Credentialing Specialist
2 weeks ago
Location: Ventura, CA
Job Type: Full-Time Regular
Department: Health Care Agency
Description
COMPENSATION AND BENEFITS
- Salary Increase: A general salary increase of 3.5% effective December 22, 2024.
- Educational Incentive: An educational incentive of 2.5% for completion of an associate's degree, 3.5% for a bachelor's degree, or 5% for a graduate's degree.
- Bilingual Incentive: Proficiency levels by exam are $0.69 per hour (Level I), $1.00 per hour (Level II), or $1.32 per hour (Level III).
- Vacation Accrual: New regular, full-time employees accrue approximately 14 days of vacation per year for the first 10,400 hours or 5 years of service; accruals increase at various milestones, topping out at 26 days a year.
- Sick Leave: Full-time regular employees accrue 3.08 hours of sick leave per pay period with an advance at hire of 40.04 hours.
- Deferred Compensation: Eligible to participate in the County's 401(k) Shared Savings Plan and/or the Section 457 Plan.
- Health Plans: Full-time employees have a flexible credit allowance for purchasing medical, dental, and/or vision insurance.
- Pension Plan: Contributions to the County's Retirement Plan and Social Security.
- Holidays: 12 paid holidays per year, including a scheduled floating holiday.
Under general supervision, this role is responsible for managing all facets of the credentialing and privileging process for licensed independent practitioners (LIPs) in accordance with established regulations and standards.
KEY RESPONSIBILITIES:
- Maintain compliance with all regulatory and accrediting requirements.
- Process initial and reappointment applications, ensuring completeness and accuracy.
- Verify and maintain current credentials files, including medical licenses and board certifications.
- Manage the credentialing database with up-to-date practitioner information.
- Conduct audits based on internal standards and regulatory requirements.
- Coordinate and document medical staff committee meetings.
- Safeguard all credentialing information with strict confidentiality.
- Assist in preparation for health plan audits and reports.
- Foster professional relationships with medical staff and organizational departments.
- Current National Association of Medical Staff Services (NAMSS) Certified Provider Credentialing Specialist (CPCS) or actively pursuing certification.
- Intermediate computer skills in Microsoft products and web-based queries.
- Previous experience in hospital medical staff or managed care credentialing.
- Familiarity with credentialing software.
- Experience in preparing agendas and taking minutes.
Working knowledge of TJC, NCQA, and CMS credentialing standards. Ability to manage multiple priorities, read complex documents, and communicate effectively with various stakeholders. Strong problem-solving and organizational skills with attention to detail.
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