Credentialing Specialist

4 weeks ago

Walnut Creek, United States Catalight Full time

The Credentialing Specialist provides administrative assistance and oversight of all clinical staff credentialing. Duties include verification of licenses and credentials, maintaining databases, ensuring staff members possess the required licenses and credentials, and coordinating enrollment with payors.

Core Responsibilities & Essential Job Functions
- Credentialing Program:

- Provide coordination to ensure practitioners’ CAQH profiles are up-to-date.
- Maintain practitioner license and certification primary source validations in the data management system.
- Complete credentialing requests from payors and other customers.
- Credential new practitioners and re-credential current practitioners.
- Work closely with the Revenue Cycle Management staff to identify and resolve any denials or authorization issues related to practitioner credentialing.
- Manage user access to the practitioner data management system.
- Other duties as assigned.
- Training and Technical Assistance:

- Provide training and technical assistance to internal and external customers on practitioner credentialing requirements and processes.
- Participate in special projects, and assist with additional duties or tasks, as assigned.
- Department Support
- Monitor queues and assign tickets to appropriate resources for resolution.
- Monitor queues to ensure Service Level Agreements are met.
- Must attend staff meetings, training courses, and other meetings as requested.

**Qualifications**:
Minimum Education, Experience & Training Equivalent to:

- High School Diploma required; bachelor’s degree preferred.
- 2+ years of experience in healthcare administration, with experience in credentialing preferred.

Knowledge & Skills:

- Sensitivity to working with an ethnically, linguistically, culturally, and economically diverse population.
- A commitment to the values of the organization while demonstrating good judgment, flexibility, patience
and discretion when dealing with confidential and sensitive matters.
- Expert in Microsoft Office (Outlook, Word, Excel, etc.), especially Excel and related computer software, technology, and databases.
- Consistently demonstrate good judgment and decision-making skills while maintaining the highest level of confidentiality.
- Work in an exciting, fast paced high energy environment while effectively multitasking and managing day-to-day responsibilities without supervision.
- Personable; able to work comfortably with individuals at all levels within the organization.
- Must be highly detail oriented.
- Strong interpersonal skills.
- High level of organizational skills and attention to detail.
- Communicate effectively verbally and in writing.
- Strong working relationships and encourage an environment of teamwork.
- Exercise confidentiality and discretion pertaining to the work environment.
- Positive attitude and a willingness to consider creative solutions to challenges.
- Strong ability to plan and prioritize to meet deadlines.
- Consistently demonstrate good judgment and decision-making skills.

Physical Requirements:

- Must be able to communicate effectively within the work environment, read and write using the primary language within the workplace.
- Visual and auditory ability to work with clients, staff and others in the workplace continuously.
- Frequent speaking and listening (25-75%) to clients, staff, and others in the workplace.
- Utilize computer and cell phone for effective communication.

Conditions of Employment
- Ability to obtain and maintain criminal record clearance through the Department of Justice (DOJ). The People & Performance Department must analyze DOJ/FBI live scan reports in accordance with applicable Federal, State, and Local laws, as well as fitness for the position.
- Ability to obtain and maintain clearance through the Office of Inspector General.
- Must attend any required training.
- COVID-19 vaccination and subsequent boosters required for any in office presence at all company locations.

Catalight

Company: Catalight

Time Type:
Full time

Compensation:
$30.00 - $35.00 Per Hour

The statements contained in this job description reflect general details as necessary to describe the principal functions of this job. It should not be considered an all-inclusive listing of work requirements. Individuals may perform other duties as assigned, including work in other functional areas as deemed fit for the organization.
Catalight is an equal opportunity employer.

  • Senior Manager, Operating Partnerships

    1 day ago

    Walnut Creek, United States KPMG-UnitedStates Full time

    Business Title:Senior Manager, Operating PartnershipsRequisition Number:111496 - 10Function:Tax ServicesArea of Interest:State:CACity:San DiegoDescription:At KPMG, you can become an integral part of a dynamic team at one of the world's top tax firms. Enjoy a collaborative, future-forward culture that empowers your success. Work with KPMG's extensive network...

  • Travel Nurse RN

    6 days ago

    Walnut Creek, United States LanceSoft Full time

    LanceSoft is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Walnut Creek, California.Job Description & RequirementsSpecialty: ED - Emergency DepartmentDiscipline: RNStart Date: 07/01/2024Duration: 13 weeks36 hours per weekShift: 12 hours, days, nightsEmployment Type: TravelPerks: W2 pay - $18.5/hr. OT pay - $27.75/hr. Days...

  • Travel Nurse RN

    6 days ago

    Walnut Creek, United States LanceSoft Full time

    Job DescriptionLanceSoft is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Walnut Creek, California.Job Description & RequirementsSpecialty: ED - Emergency DepartmentDiscipline: RNStart Date: 07/01/2024Duration: 13 weeks36 hours per weekShift: 12 hours, days, nightsEmployment Type: TravelPerks: W2 pay - $18.5/hr.OT pay -...

  • Behavioral Interventionist

    2 days ago

    Walnut Creek, United States Cortica Full time

    We are immediately hiring a Behavior Interventionist in San Rafael, San Francisco, East Bay and surrounding areas to provide play-based ABA therapy to our families in the home, community, school, or clinic. At Cortica, our mission is to design and deliver life-changing care - one child, one family, one community at a time. Ultimately, we envision a world...

  • Travel Skilled Nursing Facility Physical Therapy Assistant

    6 days ago

    Walnut Creek, United States Jackson Therapy Partners Full time

    Jackson Therapy Partners is seeking a travel Skilled Nursing Facility Physical Therapy Assistant for a travel job in Walnut Creek, California.Job Description & RequirementsSpecialty: Physical Therapy AssistantDiscipline: TherapyDuration: 6 weeksEmployment Type: TravelSetting: Skilled Nursing FacilityJackson is currently seeking a PTA for a contract position...

  • Travel Skilled Nursing Facility Physical Therapy Assistant

    1 week ago

    Walnut Creek, United States Jackson Therapy Partners Full time

    Job DescriptionJackson Therapy Partners is seeking a travel Skilled Nursing Facility Physical Therapy Assistant for a travel job in Walnut Creek, California.Job Description & RequirementsSpecialty: Physical Therapy AssistantDiscipline: TherapyDuration: 6 weeksEmployment Type: TravelSetting: Skilled Nursing FacilityJackson is currently seeking a PTA for a...

  • Medical Director- Walnut Creek, CA

    7 days ago

    Walnut Creek, United States VCA Antech, Inc. Full time

    VCA Cottage Animal Hospital in Walnut Creek, California is seeking a highly experienced Veterinarian to lead our talented team as Medical Director. This is an outstanding opportunity for a motivated veterinarian to continue practicing medicine while establishing the direction and medical quality of the hospital like a practice owner. Plus, you'll have the...

  • Medical Billing Specialist

    3 days ago

    Goose Creek, United States Interim HealthCare Staffing Full time

     Medicare/Medicaid Billing SpecialistSeeking a skilled individual to oversee all aspects of patient billing and collections in our Home Health and Hospice departments. Responsibilities include performing billing functions, ensuring timely authorizations/re-authorizations, processing payments, managing collections, and conducting follow-ups. Additionally,...

  • Senior Environmental/Remediation Engineer

    7 days ago

    Walnut Creek, United States Stantec Full time

    Grounded in safety, quality, and ethics, our experts lead their fields and guide our work with rigor, a creative spirit, and vision for growth. We draw from more than 20 technical specialties around the globe and are committed to fostering an inclusive community of diverse talents, backgrounds, and expertise. We're a place to apply your passion and...

  • Senior Environmental/Remediation Engineer

    1 month ago

    Walnut Creek, United States Stantec Full time

    Grounded in safety, quality, and ethics, our experts lead their fields and guide our work with rigor, a creative spirit, and vision for growth. We draw from more than 20 technical specialties around the globe and are committed to fostering an inclusive community of diverse talents, backgrounds, and expertise. We're a place to apply your passion and...

  • Travel Skilled Nursing Facility Physical Therapy Assistant

    6 days ago

    Walnut Creek, CA, United States Jackson Therapy Partners Full time

    Jackson Therapy Partners is seeking a travel Skilled Nursing Facility Physical Therapy Assistant for a travel job in Walnut Creek, California. Job Description & Requirements Specialty: Physical Therapy Assistant Discipline: Therapy Duration: 6 weeks Employment Type: Travel Setting: Skilled Nursing Facility Jackson is currently seeking a PTA...

  • Respiratory Care Practitioner II Registered

    1 week ago

    Walnut Creek, United States Kaiser Permanente Full time

    Job Summary: Under physician supervision, in accordance with policies and procedures approved by the Medical Director, is expected to assume primary clinical responsibility for all respiratory care modalities and to exercise considerable independent clinical judgment in the respiratory care of patients. Must be capable of serving as a technical resource...

  • Travel Skilled Nursing Facility Physical Therapy Assistant

    6 days ago

    Walnut Creek, CA, United States Jackson Therapy Partners Full time

    Jackson Therapy Partners is seeking a travel Skilled Nursing Facility Physical Therapy Assistant for a travel job in Walnut Creek, California. Job Description & Requirements Specialty: Physical Therapy Assistant Discipline: Therapy Duration: 6 weeks Employment Type: Travel Setting: Skilled Nursing Facility Jackson is currently seeking a PTA for a...

  • IT Specialist

    2 weeks ago

    Battle Creek, United States US Defense Logistics Agency Full time

    **Duties**: - Responsible for designing, configuring, monitoring, tuning, and troubleshooting security tasks in the DLA Identity, - contd Credential, and Access Management (ICAM) technical environment by adhering to the approved Change Management policies and procedures. - Provides advice for all matters related to System Applications and Products (SAP),...

  • Medicare/Medicaid Billing Specialist

    2 days ago

    Goose Creek, SC, United States Interim HealthCare Staffing Full time

     Medicare/Medicaid Billing SpecialistSeeking a skilled individual to oversee all aspects of patient billing and collections in our Home Health and Hospice departments. Responsibilities include performing billing functions, ensuring timely authorizations/re-authorizations, processing payments, managing collections, and conducting follow-ups. Additionally,...

  • Travel Nurse RN

    5 days ago

    Walnut Creek, CA, United States LanceSoft Full time

    LanceSoft is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Walnut Creek, California.Job Description & RequirementsSpecialty: ED - Emergency DepartmentDiscipline: RNStart Date: 07/01/2024Duration: 13 weeks36 hours per weekShift: 12 hours, days, nightsEmployment Type: TravelPerks: W2 pay - $18.5/hr. OT pay - $27.75/hr. Days...

  • Medical QA Specialist I

    23 hours ago

    Whites Creek, United States QTC Management, Inc. Full time

    If you're a medical professional skilled in reviewing and interpreting medical records, driven by a passion for aiding others, we're eager to connect with you! We are seeking a Medical Quality Assurance (QA) Specialist to support our Veteran Affairs Operations in Nashville, TN.   Who is Leidos QTC Health Services? We are the nation’s largest provider of...

  • Travel Skilled Nursing Facility Physical Therapy Assistant

    1 week ago

    Walnut Creek, CA, United States Jackson Therapy Partners Full time

    Jackson Therapy Partners is seeking a travel Skilled Nursing Facility Physical Therapy Assistant for a travel job in Walnut Creek, California.Job Description & RequirementsSpecialty: Physical Therapy AssistantDiscipline: TherapyDuration: 6 weeksEmployment Type: TravelSetting: Skilled Nursing FacilityJackson is currently seeking a PTA for a contract position...

  • Travel Nurse RN

    5 days ago

    Battle Creek, United States LanceSoft Full time

    LanceSoft is seeking a travel nurse RN Med Surg for a travel nursing job in Battle Creek, Michigan.Job Description & RequirementsSpecialty: Med SurgDiscipline: RNStart Date: 07/01/2024Duration: 13 weeks48 hours per weekShift: 12 hours, nightsEmployment Type: TravelOpen to 13 - 26 week contracts! Will float to other Med Surg units Will work every other...

  • Travel Nurse RN

    2 days ago

    Battle Creek, United States LanceSoft Full time

    LanceSoft is seeking a travel nurse RN Med Surg / Telemetry for a travel nursing job in Battle Creek, Michigan.Job Description & RequirementsSpecialty: Med Surg / TelemetryDiscipline: RNStart Date: 06/24/2024Duration: 13 weeks48 hours per weekShift: 12 hours, nightsEmployment Type: Travel Will float to other Med Surg units Will work every other weekend....