Credentialing Specialist

1 month ago

Tustin, United States Families Together of Orange County Full time
Job DescriptionJob DescriptionSalary: $23 - $28 per hour

Job Title:    Credentialling Specialist (Temp)


Salary:          $23-28 per hour 

Location:      Tustin, CA

Openings:    1) Positions Available

Duration:      3 Months 

 


Position Purpose: The primary responsibility of the Credentialing Specialist will be to assist with credentialing and privileging of the medical staff and related activities, including, the initial collection of documents, renewals, and processing initial appointments, and reappointments. Ensure thorough and timely verification of Clinical Providers credentialing and privileges according to the medical staff credentialing and privileging policies and procedures. The Credentialing Specialist will work with the Credentialing Lead and assist in achieving the department’s goal to maintain compliance with all contracted payers, agencies, and other regulatory agencies as appropriate.


Core Duties and responsibilities, include but are not limited to:


  • Co-manage the credentialing process for healthcare providers with the Credentialing Lead.
  • Maintain accurate and up-to-date provider information in credentialing databases, including AQH, PECOS, and NPPES.
  • Verify provider credentials, including education, licensure, and certifications via third party vendors.
  • Monitor expiring credentials such as License, DEA, CPR/BLS, privileges, ID’s, etc.
  • Communicate with providers and external organizations to obtain necessary documentation.
  • Collaborate with internal team members to resolve any credentialing discrepancies.
  • Assist with internal audits to ensure ongoing credentialing compliance.
  • Ability to adapt to changing priorities, deadlines, and workloads.
  • Other duties as assigned and within scope.



Qualifications, Skills and Experience:

 

  • 2 years of experience in healthcare credentialing, but willing to train the proper candidate with less experience.
  • Knowledgeable in the credentialing process with medical groups and insurance companies required, including Medical, Dental, or Behavioral Health.
  • Basic knowledge on navigating CAQH, PECOS systems.
  • Knowledge of medical practice operations preferred
  • Strong attention to detail and accuracy in data entry and record keeping.
  • Excellent organizational and time management skills.
  • Effective communication skills, both written and verbal.
  • Ability to work independently and as part of a team
  • Adept at communication and organization
  • Proficiency with Microsoft Office products (Word, Excel)



Families Together of Orange County (FTOC) is proud to be an equal opportunity employer.  FTOC does not discriminate based on race, color, creed, sex, sexual orientation, gender identity or expression, age, religion, national origin, disability, ancestry, marital status, veteran status, medical condition, or any protected category prohibited by local, state or federal laws.

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