Credentialing Coordinator

4 weeks ago

Alameda, California, United States Alameda Alliance Full time
Credentialing Coordinator Job Description

Job Summary: We are seeking a highly organized and detail-oriented Credentialing Coordinator to join our team at Alameda Alliance. The successful candidate will be responsible for coordinating and maintaining the credentialing and recredentialing processes of healthcare providers and practitioners.

Key Responsibilities:

  • Credentialing and Recredentialing: Coordinate and monitor the credentialing and recredentialing processes of healthcare providers and practitioners to ensure compliance with Alliance credentialing policies and regulatory agencies.
  • Application Maintenance: Prepare initial application requests for review, send and track application requests, evaluate applications for completeness and compliance, and coordinate file processing with the Credentialing Verification Organization (CVO).
  • Credentialing Database Maintenance: Perform data entry and maintain the accuracy and integrity of the credentialing database system, produce credentialing reports as required, and review expirable reports to notify the Manager of potential issues.
  • Peer Review and Credentialing Committee Maintenance: Provide administrative support for Peer Review and Credentialing Committee meetings, prepare and send email reminders to members, prepare agendas, files, and needed materials, and take minutes and complete follow-up correspondence.

Requirements:

  • Education: Bachelor's degree preferred.
  • Experience: One to three years of experience within a healthcare/managed care environment required, with a minimum of two years of previous credentialing experience preferred.
  • Certifications: NAMSS Certified Provider Credentialing Specialist (CPCS) and/or Certified Professional Medical Staff Management (CPMSM) certification preferred.

Working Conditions: This is a full-time position that requires constant sitting and working at a desk, frequent use of a telephone headset, and frequent lifting of folders and other objects weighing between 0 and 30 lbs.

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