Credentialing Specialist

3 weeks ago


Sacramento, California, United States Pacific ExecSearch Full time
Job Title: Credentialing Specialist

Job Summary:
We are seeking a skilled Credentialing Specialist to support our client in their corporate office in Sacramento. This is an onsite contract to hire opportunity with a progressive organization that specializes in connecting people with support resources and access to healthcare.

Responsibilities:
  • Gather credentials and re-credentialing materials for contracted providers.
  • Review and analyze practitioner applications and reapplications, and accompanying documents, ensuring practitioner eligibility.
  • Identify issues that require additional investigation and evaluation, validate discrepancies, and ensure appropriate follow up.
  • Prepare credentials file for completion and presentation.
  • Respond to inquiries from other healthcare organizations.
  • Assist with managed care delegated credentialing audits; conduct internal file audits.
  • Monitor the initial process for all Medical/Professional staff and delegated providers.
  • Ensure compliance with rules, regulations, policies, procedures, and delegated contracts.
  • Perform related duties as assigned.

Requirements:
  • High School Diploma or GED required. A college degree in a related field is preferred.
  • 2+ years' experience with medical administration required.
  • Experience with verifying credentials and processing new applications preferred.
  • High volume data entry experience is required.
  • IntelliSoft system experience preferred.
  • Experience with Medi-Cal preferred.
  • Strong attention to detail, focused and able to work in a fast-paced environment.
  • Excellent communication skills, both verbal and written.
  • Ability to solve mid-level problems with minimal supervision.
  • Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers.
  • Proficiency with Microsoft Office (Word, Excel, PowerPoint).
  • Ability to maintain strict confidentiality.


  • Sacramento, California, United States Medusind Full time

    Job Title: Credentialing and Enrollment SpecialistAt Medusind, we pride ourselves on delivering exceptional, cost-effective solutions to the healthcare industry. Our team's rich domain expertise and robust compliance norms enable us to provide superior services to our clients worldwide.Key Responsibilities:Evaluate, analyze, and coordinate all aspects of...

  • Scoring Specialist

    4 weeks ago


    Sacramento, California, United States Pearson Full time

    We are seeking a highly skilled Scoring Specialist to join our team at Pearson. As a Scoring Specialist, you will play a critical role in evaluating responses from teacher candidates in California.The ideal candidate will have a strong background in sciences, with a Single Subject Teaching Credential corresponding to the content field, or equivalent...


  • Sacramento, California, United States CA Department of Tax and Fee Administration Full time

    Job Description and DutiesUnder the general direction of the Information Technology Manager I, the Information Technology Specialist II works as an independent technical specialist lead on the most complex software solutions, software conversions/integrations, and systems maintenance.The incumbent participates in all stages of the Systems Development Life...


  • Sacramento, California, United States RecruitWell LLC Full time

    Pediatric Radiology OpportunityWe are seeking a skilled Pediatric Radiology Specialist to join our team at a top-rated hospital in Sacramento, California. As a Pediatric Radiology Specialist, you will be responsible for interpreting medical images and providing expert care to pediatric patients.Key Responsibilities:Interpret medical images, including X-rays,...

  • Pulmonary Specialist

    4 weeks ago


    Sacramento, California, United States MDstaffers Full time

    Pulmonary Specialist OpportunityWe are seeking a qualified Pulmonary Specialist to join our team in Sacramento, CA. This is a permanent, full-time position with a growing pulmonary critical care division. The ideal candidate will have experience in spirometry procedures and a passion for community-focused care.Key Details:Permanent, full-time...


  • Sacramento, California, United States Fortune School of Education Full time

    About Fortune School of EducationFortune School of Education is a comprehensive education system that includes non-profit preschools, a network of tuition-free public charter schools (TK-12th), and a school of education with master's programs and educator preparation programs accredited by the California Commission on Teacher Credentialing.Our MissionWe aim...


  • Sacramento, California, United States MDstaffers Full time

    We are seeking a skilled Cardiologist Specialist to join our team at MDstaffers. This is a permanent, full-time position in a hospital setting where you will provide cardiology expertise to advance heart failure programs. Your responsibilities will include cultivating and expanding the VAD program, as well as providing excellent patient...


  • Sacramento, California, United States California Correctional Health Care Services Full time

    Job SummaryCCHCS seeks to fill a permanent/full-time Information Technology Specialist II position in the Information Technology Services Division.Under the general direction of the IT Manager I, the IT Specialist II works independently as the technical expert on complex software systems and projects. The incumbent acts as a technical leader or project...


  • Sacramento, California, United States Concentra Full time

    Overview:At Concentra, we are seeking a skilled Medical Support Specialist to join our patient care team. As a vital member of our team, you will play a crucial role in providing exceptional care to our patients. Our mission is to improve the health of America's workforce, one patient at a time.The Medical Support Specialist is responsible for performing...


  • Sacramento, California, United States RecruitWell LLC Full time

    Pediatric Radiology Specialist OpportunityWe are seeking a skilled Pediatric Radiology Specialist to join our team in Sacramento, California. This locums opportunity offers a chance to work in a dynamic hospital setting, providing high-quality care to pediatric patients.Key Responsibilities:Perform diagnostic and interventional radiology procedures for...


  • Sacramento, California, United States University of California- Davis Health Full time

    Job Summary:The Respiratory Care Specialist will be responsible for planning and administering prescribed respiratory therapy to patients with critical pulmonary illness and trauma needs. This position requires a high level of technical and specialized knowledge in respiratory care, as well as excellent communication and leadership skills.Key...


  • Sacramento, California, United States CA Department of Tax and Fee Administration Full time

    Job Description and DutiesAre you interested in making a meaningful impact in your community? Do you want to create a positive change in the lives of Californians? If you answered yes to these questions, then the California Department of Tax and Fee Administration (CDTFA) has a career opportunity waiting for you.We are seeking an Information Technology...


  • Sacramento, California, United States CommonSpirit Health Full time

    Overview:At CommonSpirit Health, we are committed to providing exceptional care to our patients. Our team at Mercy General Hospital is dedicated to delivering high-quality services, with a special focus on the cardiac catheterization patient population.We are seeking a skilled Cardiac Care Specialist to join our team. As a key member of our interdisciplinary...


  • Sacramento, California, United States CommonSpirit Health Full time

    Job Summary:As a Cardiac Care Specialist at CommonSpirit Health, you will provide direct healthcare services to patients undergoing cardiac catheterization. You will synthesize theoretical, scientific, and contemporary clinical knowledge to assess and manage health and illness states. Your primary responsibilities will include evaluating normal and abnormal...


  • Sacramento, California, United States Pacific Companies, Inc. Full time

    We are seeking a skilled Cardiology Physician Specialist to provide coverage for a great facility in Sacramento, California. The ideal candidate will have experience in non-invasive cardiology and be able to work independently with minimal supervision.Job Details:Location: Sacramento, CADuration: 2-4 weeks per monthSchedule: Monday Friday, 8a-5pScope:...


  • Sacramento, California, United States California Correctional Health Care Services Full time

    Job Description and DutiesUnder the general direction of the Staff Services Manager I, the Health Program Specialist I is responsible for providing specialty healthcare service liaison duties in the Registry Network Team. This position is critical to the Department's mission to provide constitutionally adequate and cost-effective healthcare services for...


  • Sacramento, California, United States Department of Financial Protection and Innovation Full time

    Job Title and SummaryThe Department of Financial Protection and Innovation is seeking a highly skilled Information Technology Specialist I to join their team. This permanent full-time position is located in the Information Technology Services Division and will be based at the department's Sacramento office.Job ResponsibilitiesAs a Quality Assurance Tester,...

  • Clinical Specialist

    4 weeks ago


    Sacramento, California, United States BD Full time

    Job Description SummaryThe Clinical Specialist is a key resource for the execution of the Medication Delivery Solutions value-added clinical business strategy. The role implements clinical programs and initiatives that differentiate the MDS product portfolio based on improved clinical outcomes and process enhancements, resulting in a lower cost-in-use.The...


  • Sacramento, California, United States USVTA Full time

    Job OpportunityWe are seeking a highly skilled Emergency Associate Veterinarian to join our team at Mueller Pet Medical Center in Sacramento, CA.This is a unique opportunity to practice advanced medicine with a cohesive and tenured team. Our well-equipped hospital offers electronic medical records, digital radiography, blood analyzers, oxygen cages, a...


  • Sacramento, California, United States Natomas Unified School District Full time

    Natomas Unified School District is a dynamic and growing community that values the potential of every student.As a Special Education Teacher, you will play a vital role in shaping the educational journey of our students.The position is split between Larry G. Meeks Virtual Academy and Witter Ranch Elementary, both located on the same campus.Here are the key...