Current jobs related to Credentialing Operations Specialist - Flagstaff, Arizona - Northern Arizona Healthcare Corporation
-
Flagstaff, Arizona, United States Northern Arizona Healthcare Corporation Full timeJob DescriptionOverviewThe Delegated Credentialing Specialist plays a pivotal role in supporting business operations surrounding delegated credentialing. This position will execute the strategic business plan, lead day-to-day functions, and staff. Key responsibilities include providing reporting, implementation support, and managing the monitoring of...
-
Delegated Credentialing Specialist
2 weeks ago
Flagstaff, Arizona, United States Northern Arizona Healthcare Corporation Full timeJob SummaryThe Delegated Credentialing Specialist is a critical role within Northern Arizona Healthcare Corporation, responsible for supporting multiple specialty areas of business operations surrounding delegated credentialing. This position will execute the strategic business plan, lead day-to-day functions, and staff. Key responsibilities include...
-
Delegated Credentialing Specialist
3 weeks ago
Flagstaff, Arizona, United States Northern Arizona Healthcare Corporation Full timeJob Title: Delegated Credentialing SpecialistAt Northern Arizona Healthcare Corporation, we are seeking a highly skilled Delegated Credentialing Specialist to join our team. This role is responsible for supporting multiple specialty areas of business operations surrounding delegated credentialing, and will execute the strategic business plan as well as lead...
-
Delegated Credentialing Specialist
4 weeks ago
Flagstaff, Arizona, United States Northern Arizona Healthcare Corporation Full timeJob Title: Delegated Credentialing SpecialistJob Summary:The Delegated Credentialing Specialist will play a crucial role in supporting multiple specialty areas of business operations surrounding delegated credentialing. This position will execute the strategic business plan, lead day-to-day functions, and staff. The successful candidate will provide...
-
Operating Room Nurse Specialist
1 week ago
Flagstaff, Arizona, United States TotalMed Staffing Full timeJob Title: Operating Room Nurse SpecialistAs a skilled Operating Room Nurse Specialist, you will play a vital role in delivering high-quality patient care in a fast-paced surgical environment. Your expertise will encompass preparing the Operating Room team, maintaining aseptic conditions, and collaborating with surgical teams to ensure safe and efficient...
-
Steam Plant Operations Specialist
3 days ago
Flagstaff, Arizona, United States Northern Arizona Healthcare Full timeOverview: As a valued member of the Northern Arizona Healthcare team, the Steam Plant Operations Specialist plays a critical role in ensuring the safe and efficient operation of all utility systems within the hospital.Job Summary: We are seeking a highly skilled and experienced Steam Plant Operations Specialist to join our team. The successful candidate will...
-
Medical Support Specialist
4 days ago
Flagstaff, Arizona, United States Concentra Full timeOverview:We are seeking a skilled Medical Support Specialist to join our team at Concentra. As a vital member of our patient care 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. We are committed to delivering high-quality clinical care and...
-
Medical Imaging Specialist
2 weeks ago
Flagstaff, Arizona, United States AB Staffing Full timeCT Technologist OpportunityAre you a skilled and experienced medical professional looking for a new challenge? AB Staffing is seeking a talented CT Technologist to join our team of healthcare professionals. As a CT Technologist, you will play a critical role in providing high-quality patient care and contributing to the success of our clients.We are looking...
-
Medical Transportation Specialist
1 week ago
Flagstaff, Arizona, United States Rezolut Full timeMedical Transportation SpecialistRezolut Imaging is seeking a Medical Transportation Specialist to provide safe and efficient transportation of vehicles to urban or remote locations for healthcare events throughout Arizona. Key Responsibilities:- Provide transportation of vehicles to event sites and return vehicles after events- Complete documentation for...
-
Medical Transportation Specialist
2 weeks ago
Flagstaff, Arizona, United States Rezolut Full timeJob Title: Medical Transportation SpecialistRezolut Imaging is seeking a Medical Transportation Specialist to join our team. As a Medical Transportation Specialist, you will be responsible for providing safe and reliable transportation of our vehicles to urban or remote locations for healthcare events throughout Arizona.Key Responsibilities:Provide...
-
Traveling Operating Room Nurse
2 weeks ago
Flagstaff, Arizona, United States LanceSoft Full timeLanceSoft is seeking a skilled travel nurse to join their team in a dynamic Operating Room environment.Job DetailsSpecialty: Operating RoomDiscipline: Registered Nurse (RN)Duration: 13 weeksHours: 36 hours per weekShift: 12 hours, daysEmployment Type: TravelAs a travel nurse with LanceSoft, you will have the opportunity to work in a variety of settings and...
-
Maintenance Specialist
1 week ago
Flagstaff, Arizona, United States Troon Golf Full timeMaintenance SpecialistThe Maintenance Specialist at Troon Golf is responsible for ensuring the efficient and effective operation of the club's facilities and equipment. This role requires a detail-oriented individual with strong problem-solving skills and a commitment to maintaining a high standard of safety and functionality within the club.Key...
-
Warehouse Operations Specialist
1 month ago
Flagstaff, Arizona, United States ABC Supply Full timeWarehouse Operations at ABC Supply **Job Summary:** As a Material Handler at ABC Supply, you will be responsible for receiving materials, pulling orders for walk-in customers, operating forklifts, and loading products onto delivery trucks. You will also maintain a clean and efficient warehouse, respond to calls from the sales floor, and complete pick...
-
Travel Nurse ICU Specialist
4 weeks ago
Flagstaff, Arizona, United States Go Healthcare Full timeJob Title: Travel Nurse ICU SpecialistGo Healthcare is seeking a skilled Travel Nurse ICU Specialist to join their team in Flagstaff, Arizona.Job Description & RequirementsSpecialty: ICU - Intensive Care UnitDiscipline: RNDuration: 13 weeksShift: 12 hours, daysEmployment Type: TravelAs a Travel Nurse ICU Specialist, you will provide high-quality patient care...
-
Freight Operations Specialist
4 days ago
Flagstaff, Arizona, United States Arizona Department of Economic Security Full timeJob Summary:As a key member of the Arizona Department of Economic Security team, the Freight/Receiving Associate plays a critical role in ensuring the store is stocked and ready for business every day. This position involves loading and unloading trucks, moving material from the receiving area throughout the store, and operating forklifts. The successful...
-
Bakery Specialist
2 weeks ago
Flagstaff, Arizona, United States Safeway Full timeSafeway Bakery Team MemberWe are seeking a skilled Bakery Specialist to join our team at Safeway. As a key member of our bakery team, you will be responsible for preparing high-quality baked goods for our customers.Key Responsibilities:Measure and mix ingredients to prepare batters, dough, fillings, and icings.Operate mixing machines and steam kettles to...
-
Accounts Payable Specialist
4 weeks ago
Flagstaff, Arizona, United States Vaco Full timeAccounts Payable SpecialistWe are seeking an experienced Accounts Payable Specialist to join our team at Vaco. As a key member of our financial operations team, you will be responsible for managing accounts payable processes, reconciling accounts, and fostering vendor relationships.Key Responsibilities:Manage accounts payable processes, including invoice...
-
Operating Room Travel Nurse RN Position
2 weeks ago
Flagstaff, Arizona, United States MedPro Healthcare Staffing Full timeMedPro Healthcare Staffing is seeking a travel nurse RN specializing in Operating Room for an assignment in a hospital setting. The ideal candidate will have at least 18 months of recent experience in an Acute Care Surgery environment and should hold an active RN license.Benefits include weekly pay, full coverage of all credentialing fees, and housing...
-
Travel Operating Room Nurse
3 weeks ago
Flagstaff, Arizona, United States Focus Staff Full timeJob Title: Travel Operating Room NurseFocus Staff is seeking a skilled Operating Room Nurse for a travel contract in Flagstaff, AZ. The ideal candidate will have at least 1 year of experience in a OR setting.Job Requirements:1 Year of Experience, 2 PreferredValid AZ RN LicenseBLS (Basic Life Support)ACLSEligible to work in the United StatesBenefits:Health...
-
Travel Operating Room Nurse
2 weeks ago
Flagstaff, Arizona, United States Focus Staff Full timeJob Title: Travel Operating Room NurseFocus Staff is seeking a skilled Operating Room Nurse for a travel contract in Flagstaff, AZ. The ideal candidate will have at least 1 year of experience in a OR setting.Benefits:Competitive payHealth insuranceVision insuranceDental insuranceLife insuranceLicensure reimbursementTravel reimbursementRelocation...
Credentialing Operations Specialist
2 months ago
Position Summary
The Credentialing Operations Specialist plays a crucial role in overseeing various aspects of business operations related to delegated credentialing. This role is pivotal in executing strategic initiatives and managing daily operations and personnel. The specialist will be responsible for reporting, implementation support, and monitoring programs associated with services provided through contracted delegated entities, ensuring alignment with the organization's strategic goals and objectives.
Key Responsibilities
Essential Functions
* Ensure compliance with NCQA standards.
Conduct audits of provider licensure files to meet NCQA criteria.
Retrieve ongoing files in accordance with NCQA requirements.
Possess a thorough understanding of initial and re-credentialing delegated files.
Manage delegated credentialing submissions to payers.
Prepare and distribute applications for facilities and providers to payers.
Coordinate, oversee, and maintain all credentialing and re-credentialing processes.
Upload and update the system with necessary documentation.
Engage in ongoing communication with payers.
Assist internal departments and offices with credentialing inquiries.
Utilize licensure portals effectively.
Source effective dates from payers and notify relevant parties.
Maintain records related to licenses, credentials, and insurance contracts.
Oversee all changes related to insurance.
Respond promptly to payer inquiries.
Track provider renewal dates.
Evaluate monthly and quarterly updates to payer directories.
Communicate with providers as necessary.
Revise policies and procedures as needed.
Ensure thorough preparation of documentation, reports, and other information required for regulatory and NCQA audits concerning delegation oversight.
Confirm that delegated provider credentialing audits are conducted by the delegated credentialing team for initial, annual, and interim assessments in compliance with Joint Commission, NCQA, CMS, state, and federal regulations.
Ensure that the delegated credentialing process meets provider customer expectations through reports and trend analysis.
Guarantee the timely completion of annual delegated credentialing audits and corrective action plans. Manage credentialing rosters, reports, and compliance for delegated providers.
Act as a liaison between delegated providers and internal stakeholders.
Assist in negotiating delegated agreements.
Maintain up-to-date knowledge of regulatory credentialing requirements.
Engage in additional projects as assigned.
Compliance and Safety
* Ensure all necessary certifications and licenses are current and valid prior to expiration.
Complete all mandatory training modules and job-specific training within the designated timeframe.
Report any safety-related incidents promptly through the appropriate channels; participate in all safety training programs; perform work safely; monitor the work environment for potential safety issues and ensure compliance among colleagues.
Stay informed about cybersecurity trends, developments, best practices, and regulatory changes.
Qualifications
Education
* High School Diploma is required.
Certification & Licensures
* Certification as a Provider Credentialing Specialist (CPCS) is preferred.
Experience
* A minimum of 2-3 years of experience in Healthcare Credentialing is required, with CPCS certification preferred.
* Experience in Health Plan Delegation is preferred.
* Strong verbal and written communication skills are essential.
* Must be well-organized and detail-oriented with the ability to manage multiple tasks effectively.
* Proficiency in Microsoft Office applications, including Word and Outlook, is required.
* Ability to work independently with minimal supervision and prioritize tasks efficiently.
