Credentialing Coordinator

2 weeks ago


Long Beach, California, United States HealthCHEC Full time

Position Overview

As 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 HealthCHEC

HealthCHEC is dedicated to addressing the healthcare needs of diverse populations, focusing on delivering quality services and support to enhance the well-being of individuals. Our organization prides itself on being a leader in the healthcare sector, committed to innovation and excellence in service delivery.

Key Responsibilities

- Assist in the management of credentialing processes by collecting, tracking, and reviewing necessary documentation to meet compliance standards.
- Maintain accurate and up-to-date files on practitioners, ensuring all certifications are current and valid.
- Develop and nurture professional relationships with healthcare providers and groups to facilitate smooth credentialing operations.
- Serve as a knowledgeable resource for internal teams and external partners, providing guidance on credentialing practices and compliance requirements.
- Champion adherence to corporate audit policies and procedures, addressing escalated issues as they arise.

Your Role Includes

- Supporting the credentialing auditors with the processing of initial and re-credentialing applications, verifying eligibility through comprehensive documentation reviews.
- Collecting data from various sources, including the National Practitioner Data Bank, to ensure thorough and accurate credentialing.
- Educating delegated entities on submission requirements to ensure compliance with CMS and NCQA standards.
- Assisting with credentialing audits and tracking corrective action plans for timely documentation submissions.
- Collecting and reviewing submissions during regulatory audits to ensure compliance with CMS requirements.
- Providing exceptional customer service in line with organizational principles and maintaining confidentiality of sensitive information.

Qualifications

- An Associate's Degree or equivalent experience is required.
- A minimum of 3 years of experience in a healthcare or managed care setting is essential.
- Proficiency in data entry and strong organizational skills are necessary for success in this role.
- Excellent communication skills, both verbal and written, are crucial for effective collaboration.
- Ability to multitask and thrive in a fast-paced environment while maintaining attention to detail.
- Proficiency in MS Office applications is required.

Benefits

- Competitive salary range with opportunities for performance-based bonuses.
- Comprehensive wellness programs and generous paid time off policies.
- Eleven paid holidays annually, plus an additional floating holiday.
- A robust 401(k) retirement savings plan with employer matching contributions.
- Employee recognition programs and tuition reimbursement opportunities.
- A supportive work-life balance to enhance employee satisfaction.

Join us at HealthCHEC, where we are committed to improving the health and well-being of our communities through dedicated service and innovative healthcare solutions.



  • 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, 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, 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...


  • 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...


  • 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...


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

    Job OverviewPOSITION SUMMARYThis role reports directly to the Director of Provider Engagement. The individual will play a crucial role in assisting the Provider Engagement Department with the management of IPA Regional Networks. Responsibilities include effective communication with client leadership and physicians, addressing physician concerns, and...


  • Long Beach, California, United States Dental Health Services Full time

    Job OverviewWe are seeking a highly skilled and experienced Professional Services Support Manager to join our team at Dental Health Services. This is a full-time position that will play a critical role in overseeing the Professional Services Support department's personnel, activities, and functions.Key ResponsibilitiesLead and direct the Professional Support...


  • Long Beach, California, United States MemorialCare Health System Full time

    Position Overview Title: Chief Medical Staff Operations Officer Location: Long Beach, CA Department: Medical Staff Services Employment Type: Full-time Work Schedule: Day Shift Compensation Range: $135,000 - $203,000 annually MemorialCare Health System is a leading nonprofit healthcare organization that encompasses four top-tier hospitals...


  • Long Beach, California, United States The California State University Full time

    Job SummaryWe are seeking a highly qualified Academic Professional in Physical Education to join our team at The California State University. The successful candidate will be responsible for teaching undergraduate and graduate courses in Physical Education Teacher Education (PETE) curriculum, developing and enhancing PETE at the graduate level, and...


  • Long Beach, California, United States OPT FOR HEALTHY LIVING Full time

    Job SummaryOPT FOR HEALTHY LIVING is seeking a highly qualified Physical Education Professor to join our team. As a key member of our faculty, you will be responsible for teaching undergraduate and graduate courses in Physical Education Teacher Education (PETE) curriculum, developing and enhancing PETE at the graduate level, and coordinating K-12 teacher...


  • Long Beach, California, United States Blue Shield of California Full time

    About the RoleThe Commercial Markets Analytics team at Blue Shield of California provides financial reporting and utilization/clinical analytics to Commercial employers and their Brokers/Consultants. As a Medical Informatics Analyst, Consultant, you will report to the Senior Manager of Commercial Markets Analytics in Data & Analytics under Information...


  • Long Beach, California, United States Element Consulting Full time

    Job OverviewPosition: Construction ManagerEssential Requirement: Must possess K-12 California school construction experience.Role Summary:Oversees and directs all aspects of the construction phase for K-12 educational facility projects, including mobilization, execution, and project closeout.Plans, organizes, and reports on construction management activities...


  • Long Beach, California, United States Element Consulting Full time

    Job OverviewPosition: Construction ManagerEssential Requirement: K-12 California School Construction ExperienceRole Summary:Oversees and directs all aspects of the construction phase for K-12 educational facility projects, encompassing mobilization, execution, and project closeout.Organizes, plans, and reports on construction management activities and...


  • Long Beach, California, United States Element Consulting Full time

    Job OverviewPosition: Construction ManagerEssential Requirement: Must possess K-12 California school construction experience.Role Responsibilities:Oversee and coordinate all aspects of the construction phase for K-12 educational facility projects, including mobilization, execution, and project closeout.Plan, organize, and report on construction management...


  • Long Beach, California, United States OPITONS FOR YOUTH CHARTER SCHL Full time

    Position Overview:As an Educational Support Specialist, you will play a vital role in enhancing the educational experience for students with unique learning needs. Your commitment to fostering an inclusive environment will empower students to achieve their fullest potential.Key Responsibilities:Deliver tailored instruction to students with special needs and...


  • Long Beach, California, United States Fenix Marine Services Full time

    About the Company:Fenix Marine Services is a leading terminal management team providing crucial operations in a fast-paced industrial environment. We value diversity and offer equal opportunities to all employees.Description:The Operations Manager plays a key role in the Fenix Marine Services Terminal Management Team. Reporting to the department manager, the...


  • Long Beach, California, United States MOL (Americas) LLC Full time

    Position: Senior Manager, Marine Operations Professional Level Reports to: General Manager of Area Operations & Contract Management, General Manager of Marine Quality & Safety Management Job Classification: Exempt Overview The Senior Manager of Marine Operations at MOL (Americas) LLC is tasked with overseeing vessel operations, ensuring...