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Insurance Credentialing Specialist
2 months ago
Salud Para La Gente (SALUD) is dedicated to delivering high-quality, comprehensive, and affordable medical, dental, behavioral health, and optometry services to underserved, low-income communities in the Monterey Bay area. Established in 1978, SALUD has evolved into a Federally Qualified Health Center (FQHC) with multiple health center locations and a workforce exceeding 400 employees, all committed to excellence in patient care.
Position SummaryWe are in search of a qualified Credentialing Coordinator to facilitate the efficient and accurate credentialing and re-credentialing processes for our healthcare providers. Reporting to the Billing Manager, this role is crucial in ensuring that all providers maintain current insurance credentials. The ideal candidate will align with our mission to provide exceptional healthcare services to individuals of all ages.
Key Responsibilities- Manage and complete insurance credentialing and re-credentialing applications for providers, ensuring timely follow-up on submissions for commercial insurances, Medi-Cal, and Medicare.
- Oversee the credentialing processes for healthcare facilities, ensuring compliance with all requirements.
- Maintain both electronic and physical files for provider credentialing documentation.
- Stay informed about current health plan and agency credentialing requirements.
- Organize and update provider information in online credentialing systems.
- Ensure that practice addresses are accurately represented with health plans and agencies.
- Verify all aspects of the credentialing process for healthcare providers and facilities.
- Safeguard the confidentiality of provider information.
- Enroll and maintain SALUD practice locations with relevant health plans.
- Ensure timely credentialing for both healthcare providers and facilities.
- Enhance existing credentialing workflows for efficiency.
- Perform additional duties as assigned.
Minimum Requirements:
- Associate's Degree or equivalent experience with at least two years of post-secondary education.
- A minimum of two years of experience in health insurance billing or a related field.
- Exceptional verbal and written communication skills.
- Strong analytical and research capabilities.
- Meticulous attention to detail.
- Proficiency in Microsoft Office Suite, particularly Word and Excel.
- Effective project management skills, with the ability to prioritize and manage multiple tasks.
- Ability to work independently and efficiently with minimal supervision.
Preferred Qualifications:
- Bilingual in Spanish and bicultural experience is preferred.
The hourly wage for this position is $34.69. Benefits include medical, dental, vision, life insurance, 401(k), holiday pay, and paid time off.
Physical Requirements- This role requires a full range of motion, including standing, walking, sitting, typing, reaching, bending, and lifting up to 25 pounds.
- Frequent use of a computer keyboard is necessary.
- Ability to sit for extended periods is required.
Salud Para La Gente is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity, national origin, veteran status, or genetic information. We are committed to providing equal access and reasonable accommodations for individuals with disabilities in employment and our services.
