Certified Credentialing Specialist

5 days ago

Yakima, United States Yakima Neighborhood Health Services Full time
This job requires that you be fully vaccinated against COVID-19.

**Not a remote position**

Who We Are:

Established in 1975, Non-Profit Yakima Neighborhood Health Services serves patients in the areas of Behavioral Health, Family Dentistry, Internal Medicine, Women's Health, Primary Care, Pediatrics, Vision Care and Pharmacy. Our mission is to improve the quality of life and equity in our communities by providing accessible and integrated health and social services, ending homelessness and offering unique learning opportunities for students of health professions.

Yakima Neighborhood Health Services is an Equal Opportunity Employer. We celebrate diversity in the workplace and are committed to an inclusive work environment

Why Work at Yakima Neighborhood Health Services?

YNHS offers great compensation for this position, with a starting wage of $22-$35 an hour, along with high value benefits of employer provided medical, dental, vision, life, disability and retirement insurances. To support our team, we also provide 10 paid holidays, flexible amounts of paid leave and/or cash-out options, and retention bonuses to reward commitment to our mission. YNHS is a positive, supportive community with which to work. Consider joining our team

Our Ideal Candidate: Education for this position requires a certification or at least two years of related experience in credentialing and re-credentialing processes. Preference and special consideration will be given to individuals certified as Provider Credentialing Specialists (CPCS) or Professional Medical Services Management Specialists (CPMSM). Must possess experience with electronic verification systems and credentialing databases; including NPPES. Candidate has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency. This is an opportunity for a qualified candidate to join YNHS in its mission. YNHS is looking for a Certified Provider Credentialing Specialist to help YNHS identify quality providers for our integrated health care team.

Day to Day:
  • Complete credentialing process for the organization and the providers, including initial applications and re-credentialing.
  • Review and authenticate credentials, qualifications, licenses, certifications, and other relevant documents submitted by individuals or organizations to assure information provided is accurate and meets the required standards of YNHS credentialing policies.
  • Provide primary source verification of documentation provided by employees and contractors.
  • Maintain accurate and up-to-date provider records within the credentialing database, ensuring data integrity and compliance with internal policies.
  • Ensure adherence to state and federal regulations regarding healthcare provider credentialing and practice standards. This position is responsible for staying current with regulations specific to health care, HRSA, Joint Commission, and other entities which YNHS may be accountable to.
  • Work collaboratively with various departments to gather required documentation and facilitate the credentialing process.
  • Collaborate with the Chief Medical Officer and Revenue Cycle Manager to address any credentialing-related issues or inquiries.
  • Serve as the primary contact for providers regarding their credentialing status and related inquiries.
  • Monitor expiration dates of licenses and certifications, ensuring timely renewals and re-credentialing.
  • Assist in the development and implementation of credentialing policies and procedures, staying informed about regulatory changes that impact credentialing practices.
  • Perform other duties as assigned or as needed, including general administrative and billing support.

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