Current jobs related to Credentialing Coordinator - Long Beach - SCAN


  • Long Beach, United States Advanced Medical Manage Full time

    Job DescriptionJob DescriptionRole InsightsThis role of a Credentialing Coordinator is considered an essential position within the organization. This individual is responsible for verifying the credentials of our contracted practitioners and ensuring they meet all requirement regarding state licensure, graduate education, and training as per AMM, NCQA, CMS...


  • Long Beach, California, United States HealthCHEC Full time

    Position Title: Credentialing CoordinatorWork Arrangement: RemoteEmployment Type: Full-TimeAbout HealthCHECHealthCHEC is a dedicated organization focused on addressing the significant challenges faced by older adults in the United States. As a leader in the healthcare sector, we are committed to enhancing the well-being and independence of seniors,...


  • Long Beach, CA, United States Argus Medical Management, LLC Full time

    About Us:At Argus Medical Management, LLC, we pride ourselves on being a leading physician practice management organization in Southern California, overseeing a network of over 200 clinics in Long Beach and its neighboring areas. Since our inception in 1995, we have been dedicated to enhancing the healthcare landscape through innovative management solutions...


  • Long Beach, California, United States HealthCHEC Full time

    Position OverviewAs a Credentialing Coordinator, you will play a vital role in supporting the credentialing process within a remote work environment. This full-time position is essential for ensuring compliance with healthcare regulations and maintaining high standards in practitioner credentialing.About HealthCHECHealthCHEC is dedicated to addressing the...


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job OverviewPosition SummaryThe Credentialing Coordinator plays a vital role within Advanced Medical Manage. This position is tasked with the essential duty of validating the qualifications of our network practitioners, ensuring compliance with state licensure, educational background, and training standards as mandated by relevant regulatory bodies and our...


  • Long Beach, California, United States SCAN Health Plan Full time

    About SCAN Health PlanSCAN Group is a not-for-profit organization committed to addressing the significant challenges faced by older adults across the United States. As the sole corporate member of SCAN Health Plan, we are recognized as one of the nation's premier not-for-profit Medicare Advantage plans, serving over 270,000 members in multiple states. With...


  • Long Beach, United States Argus Medical Management, LLC Full time $24 - $28

    *About Us:*Apply below after reading through all the details and supporting information regarding this job opportunity.Welcome to Argus Medical Management! With over 25 years of experience, we’re proud to be one of the leading physician practice management companies in Southern California. Operating and managing over 200 clinics in Long Beach and the...

  • Credentialing Manager

    1 month ago


    Long Beach, United States Advanced Medical Manage Full time

    Job DescriptionJob DescriptionPOSITION SUMMARYThe Credentialing Manager is responsible for managing a team of credentialing professionals and is accountable for systems and processes that ensure compliance with organizational credentialing policies and procedures, and compliance with the credentialing requirements of our health plan partners, and related...


  • Miami Beach, United States Mount Sinai Medical Center of Florida Full time

    This individual is assigned the responsibility of assisting the Director of medical staff services with all aspects of the credentialing and maintenance of files for medical staff and allied health practitioners. Responsibilities: Processes applicant Credentialing, Coordinator, Staff, Medical, Healthcare, Business Services


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job OverviewPosition SummaryThe Credentialing Coordinator plays a pivotal role within Advanced Medical Manage. This position is dedicated to the thorough verification of the qualifications of our network practitioners, ensuring compliance with all necessary standards related to state licensure, educational background, and training in accordance with AMM,...


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job OverviewPOSITION SUMMARYThe Credentialing Operations Supervisor is tasked with leading a team of credentialing specialists and ensuring adherence to the organization's credentialing standards and protocols. This role is pivotal in maintaining compliance with the credentialing mandates of our health plan affiliates, as well as relevant regulatory and...


  • Daytona Beach, Florida, United States NASCAR Full time

    Become a vital part of our team at NASCARSupport the credentialing process for eventsManage the credential office operations during race events to ensure proper distribution of credentialsAre you eager to contribute to the thrill of the racing world? We are seeking dedicated individuals to join our collaborative team at NASCAR. As an Equal Opportunity...


  • Miami Beach, Florida, United States Mount Sinai Medical Center of Florida Full time

    Job Summary:The Credentialing Coordinator will assist the Director of Medical Staff Services with all aspects of credentialing and maintenance of files for medical staff and allied health practitioners. This role is a critical component of the Mount Sinai Medical Center of Florida's commitment to delivering high-quality patient care.Key...


  • Miami Beach, Florida, United States Mount Sinai Medical Center of Florida Full time

    About the RoleMount Sinai Medical Center of Florida is seeking a highly skilled Credentialing Coordinator to join our team. As a key member of our Medical Staff Office, you will play a vital role in ensuring the smooth operation of our credentialing process.Key ResponsibilitiesInitial Medical Staff Appointment Processing: Assist the Director of Medical Staff...

  • Contract Coordinator

    2 months ago


    Long Beach, United States Advanced Medical Manage Full time

    Job DescriptionJob DescriptionTITLEContract CoordinatorPOSITION SUMMARYWe are looking for a motivated and detail-oriented Contract Coordinator to manage and oversee thecontract administration process for our company. The ideal candidate will be responsible forcoordinating provider contracting aspects from initial outreach of a provider to final execution of...

  • Contract Coordinator

    1 month ago


    Long Beach, United States Advanced Medical Manage Full time

    Job DescriptionJob DescriptionTITLEContract CoordinatorPOSITION SUMMARYWe are looking for a motivated and detail-oriented Contract Coordinator to manage and oversee thecontract administration process for our company. The ideal candidate will be responsible forcoordinating provider contracting aspects from initial outreach of a provider to final execution of...


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job OverviewPOSITION SUMMARYThe Provider Engagement Coordinator, reporting to the Director of Provider Engagement, plays a crucial role in supporting the operations of IPA Regional Networks. This position is essential for facilitating communication between client leadership and healthcare providers, addressing physician concerns, and collaborating with...


  • West Palm Beach, Florida, United States Foundations for Living Full time

    About the RoleWe are seeking a highly skilled and experienced professional to join our team as a Director of Medical Staff Services. This is a critical role that requires strong leadership and management skills, as well as a deep understanding of medical staff services and accreditation standards.Key ResponsibilitiesOversee the credentialing and privileging...


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job OverviewPOSITION SUMMARYThe Provider Engagement Coordinator reports directly to the Director of Provider Engagement. This role is essential in assisting the Provider Engagement Department with the operational management of IPA Regional Networks. Responsibilities include effective communication with client leadership and physicians, addressing physician...


  • Long Beach, California, United States Advanced Medical Manage Full time

    Job DescriptionJob Summary:We are seeking a highly motivated and detail-oriented Contract Administration Specialist to join our team at Advanced Medical Manage. As a Contract Administration Specialist, you will play a critical role in managing and overseeing the contract administration process for our company.Key Responsibilities:Coordinate the contract...

Credentialing Coordinator

1 month ago


Long Beach, United States SCAN Full time
About SCAN

SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation's leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, Nevada, Texas and New Mexico. SCAN has been a mission-driven organization dedicated to keeping seniors healthy and independent for more than 40 years and is known throughout the healthcare industry and nationally as a leading expert in senior healthcare. SCAN employees are a group of talented, passionate professionals who are committed to supporting older adults on their aging journey, while also innovating healthcare for seniors everywhere. Employees are provided in-depth training and access to state-of-the-art tools necessary to do their jobs, as well as development and growth opportunities. SCAN takes great pride in recognizing our team members as experts in their fields and rewarding them for their efforts. If you are interested in becoming part of an organization that is innovating senior healthcare visit www.thescangroup.org, www.scanhealthplan.com, or follow us on LinkedIn, Facebook, and Twitter.

The Job

Supports and facilitates the delegated reporting requirements by collecting, tracking, and reviewing CMS required submissions, including assistance with administrative tasks pertaining to practitioner credentialing. The Network Compliance Coordinator will assist with credentialing and will organize, maintain, and verify all aspects of the process, maintain current files on practitioners and track expiration of certifications to maintain up-to-date files. Develops and maintains a good working relationship with the providers and groups. Availability to serve as a source of guidance and experience, including, answering questions, providing examples of compliant methodology for superior job performance. Champions compliance with official corporate audit policies and procedures. Serve as a resource and assist with escalated issues and tasks, as needed.

You Will

Assisting Network Compliance Auditors with processing initial credentialing and re-credentialing applications, screening practitioners' applications and supporting documentation to ascertain eligibility, collecting information from the National Practitioner Data Bank (NPBD), the applicant and other relevant sources, identifying discrepancies in information and conducting follow-ups, presenting applications to the Credentialing Committee, assisting and responding to credentialing inquiries, capturing primary source documentation in computer databases and ensuring compliance with applicable laws, regulations, procedures, and policies.

Provides education to delegated entities to ensure that they submit complete and accurate data according to CMS and National Committee for Quality Assurance (NCQA) specifications. Functions as the point of contact for delegates on CMS required credentialing submissions. This includes, sending credentialing requirements to FDRs within identified deadlines.

Assisting Network Compliance Credentialing Auditors with initial, annual and focus credentialing delegation audits.

Issues and tracks Corrective Action Plans to groups that do not submit required documentation timely and accurately.

Facilitates and supports the entire Delegation Oversight Unit's timely collection of required delegate submissions.

Collects, tracks, and reviews delegate submissions for CMS required documentation. Including during such time that SCAN is engaged in a CMS Program Audit or other regulatory audits.

Supports the First Tier Downstream and Related Entity (FDR) Medicare Advantage Compliance program through collecting, tracking and trending attestations, and monitoring compliance within CMS requirements.

Provides internal and external customer service following SCAN Service Principles.

Utilizes department documentation including policies and procedures, desktop policies and job aids, work plans, staff education materials and other documents to ensure improved efficiency, productivity and outcomes.

Maintains the provider networks, customer's and member's rights to privacy and protects SCAN operations by keeping information confidential.

Adheres to all quality, compliance, and regulatory standards to achieve Network Management and SCAN outcomes.

Contributes to team efforts by accomplishing related results as needed.

Actively supports the achievement of SCAN's Vison and Goals.

Your Qualifications

Required:

- Associate's Degree or equivalent experience required.

- 3+ years of experience in a Healthcare or managed care environment required.

- Proficiency with data entry required.

- Ability to achieve work objectives by utilizing critical thinking skills in the decision-making process.

- Excellent communication skills and the ability to express ideas concisely and clearly orally and in writing.

- Strong organizational skills and the ability to prioritize.

- Strong interpersonal skills.

- Demonstrated customer service skills.

- Ability to multi-task and work with limited supervision.

- Ability to work well in a fast-paced and dynamic environment.

- Proficient in MS Office.

Preferred, if applicable:

- Bachelor's Degree preferred.

- Working knowledge of Medicare and Medi-Cal guidelines, preferred.

- 3+ years of experience with credentialing preferred.

What's in it for you?

  • Base salary range: $23.51 to $37.60 per hour
  • An annual employee bonus program
  • Robust Wellness Program
  • Generous paid-time-off (PTO)
  • Ten paid holidays per year, plus 1 additional floating holiday
  • Excellent 401(k) Retirement Saving Plan with employer match and contribution
  • Robust employee recognition program
  • Tuition reimbursement
  • An opportunity to become part of a team that makes a difference to our members and our community every day


We're always looking for talented people to join our team Qualified applicants are encouraged to apply now

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

SCAN is proud to be an Equal Employment Opportunity and Affirmative Action workplace. Individuals seeking employment will receive consideration for employment without regard to race, color, national origin, religion, age, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender perception or identity, age, marital status, disability, protected veteran status or any other status protected by law. A background check is required.

#LI-CS2

#LI-Remote

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)