Credentialing Specialist
7 hours ago
We are seeking a highly skilled Credentialing Specialist to join our team at Southern California Spine. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of provider credentialing and privileging processes.
Responsibilities:- Develop and implement credentialing processes and procedures to ensure compliance with regulatory requirements.
- Credential physicians and allied health professionals, including primary source verification of medical licensure and certification.
- Collect and maintain accurate practitioner databases, analyzing verifications and ensuring timely processing of credentialing and re-credentialing files.
- Manage and maintain provider CAQH and PECOS credentials, ensuring compliance with Medicare and other insurance payers.
- Correct payments or denials, exercising good judgment and interpreting medical claim data and contracts.
- Maintain teamwork, customer service, production, and quality standards to ensure timely and efficient call resolution.
- Ensure compliance with regulatory and accrediting bodies, including NCQA and state and federal standards.
- Analyzing verifications and establishing a system for timely processing of credentialing and re-credentialing files.
- Maintaining current knowledge of NCQA, state, and federal requirements.
- Performing data entry and maintaining currency of the database for tracking practitioner/HDO credentialing and re-credentialing information.
- Initiating and conducting primary source verification of provider credentials.
- CPCS, CPMSM, NAMSS, GOLD, ECFMG, DEA, BEP/WBE/MBE, NEMT, CPMSC, CMSC certifications.
- Associate's or Bachelor's degree in a related field, such as healthcare, business, or education.
- Medical terminology, statutes and laws relating to credentialing, NCQA, Microsoft Office, and accreditation and certification procedures.
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Credentialing Specialist
3 weeks ago
El Centro, California, United States Southern California Spine Full timeJob DescriptionOverviewSouthern California Spine is seeking a highly skilled Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring the accuracy and completeness of provider credentialing and privileging processes.ResponsibilitiesDevelop and implement credentialing processes and procedures to...
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Credentialing Specialist
6 days ago
El Monte, California, United States Nexus HR Services Full timeJob Title: Credentialing SpecialistWe are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at Nexus HR Services.Job Summary:The Credentialing Specialist will be responsible for overseeing and managing the credentialing processes for healthcare professionals within our organization. This includes creating and...
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Credentialing Support Specialist
4 weeks ago
El Cajon, California, United States La Maestra Community Health Centers Full timeCredentialing Support Specialist Position at La Maestra Community Health CentersOverview:We are seeking a Credentialing Support Specialist to assist our Credentialing Coordinator in overseeing the licensing and credentialing processes for our healthcare providers.Key Responsibilities:Help maintain and monitor the credentialing roster, employee health...
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Credentialing Specialist
3 days ago
El Monte, California, United States Nexus HR Services Full timeJob Title: Credentialing CoordinatorWe are seeking a highly organized and detail-oriented Credentialing Coordinator to join our team at Nexus HR Services.Job Summary:The Credentialing Coordinator will be responsible for overseeing and managing the credentialing processes for healthcare professionals within our organization. This includes maintaining...
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Curriculum and Instruction Specialist
2 weeks ago
El Centro, California, United States Imperial County Office of Education Full time{"title": "Curriculum and Instruction Specialist", "content": "About UsWe are committed to improving the quality of life in Imperial County by promoting strong families and students who are prepared for life, college, and career.Our MissionWe strive to provide a safe, courteous, and professional environment that fosters teamwork and professional development...
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IEP Case Manager
3 weeks ago
El Centro, California, United States Central Union High School District Full timeJob SummaryCentral Union High School District is seeking a highly skilled IEP Case Manager to join our team. This is a non-teaching role that involves the case management of IEPs for students with mild/moderate learning differences.Key Responsibilities:Full administration of the IEP process for assigned caseloadEnsuring services and supports are in place and...
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Credentialing Administrative Assistant
4 hours ago
El Cajon, California, United States La Maestra Community Health Centers Full timeJob DescriptionLa Maestra Community Health Centers is seeking a skilled Credentialing Administrative Assistant to join our team. The successful candidate will assist the Credentialing Coordinator in all aspects of licensing and credentialing for providers, ensuring compliance with regulatory requirements and company policies.Key Responsibilities:• Maintain...
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After School Program Support Specialist
3 weeks ago
El Centro, California, United States Volunteers of America Full timeJob OverviewLocationEl Centro, CAAbout Us:Volunteers of America is dedicated to providing support and resources to communities. We are committed to fostering an environment where children can thrive through innovative educational programs. We are currently looking for a compassionate individual to assist in our After School Program, focusing on enhancing the...
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Travel Physical Therapist
2 weeks ago
El Centro, California, United States LanceSoft Full timeJob DetailsLanceSoft is seeking a skilled Physical Therapist for a travel assignment in California.Job RequirementsSpecialty: Physical TherapistDiscipline: TherapyDuration: 11 weeks40 hours per weekShift: 8 hours, daysEmployment Type: TravelCA State license requiredAbout LanceSoftLanceSoft is a Certified MBE and Woman-Owned organization. We offer short- and...
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Travel Physical Therapist Position
6 days ago
El Centro, California, United States LanceSoft Full timeJob Title: Travel Physical TherapistLanceSoft is seeking a skilled Physical Therapist to join our team for a travel assignment in California.Job Details:Specialty: Physical TherapyDiscipline: TherapyShift: 8 hours, daysDuration: 11 weeksHours per week: 40About LanceSoft:LanceSoft is a Certified MBE and Woman-Owned organization established in 2000. We are one...
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Travel Physical Therapist Position
4 days ago
El Centro, California, United States LanceSoft Full timeJob Title: Travel Physical TherapistLanceSoft is seeking a skilled Physical Therapist to join our team for a travel assignment in El Centro, California.Job Details:Specialty: Physical TherapistDiscipline: TherapyAssignment Length: 11 weeksTotal Hours Per Week: 40Shift Breakdown: 5x8 hoursThis travel Physical Therapist job offers a unique opportunity to work...
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Mild/Moderate Special Education Instructor
4 weeks ago
El Centro, California, United States Central Union High School District Full timePosition Overview The Central Union High School District is seeking a dedicated and compassionate Mild/Moderate Special Education Instructor. We are in search of an individual who prioritizes the educational needs of students and aligns with our mission to prepare them for future academic and career opportunities. Our core values emphasize honesty,...
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El Centro, California, United States Central Union High School District Full timeJob SummaryCentral Union High School District is seeking two School Psychologists to join our team, commencing with the upcoming school year.Key Responsibilities:Provide psychological services to schools, including testing, counseling, and consulting to support students' educational needs.Conduct psycho-educational evaluations, prepare reports, and present...
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Family Nurse Practitioner
2 weeks ago
El Centro, California, United States Molina Healthcare Full timeJob SummaryMolina Healthcare is seeking a highly skilled Family Nurse Practitioner to join our team of healthcare professionals. As a Family Nurse Practitioner, you will play a critical role in providing high-quality, patient-centered care to our members in various settings, including home, community, and nursing facilities.Key ResponsibilitiesProvide...
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Geriatric Care Specialist
4 weeks ago
El Cajon, California, United States AMN Healthcare Full timeJob Overview & RequirementsGeriatric Care SpecialistThis organization is in search of a Geriatric Care Specialist to provide temporary support as they address an immediate requirement.Key Details and Qualifications:Work Schedule: Monday - Friday, 8 AM - 5 PMPractice Environment: OutpatientCase Types: PACE program, elder careCredentialing Duration:...
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Inclusion Specialist for Elementary Education
4 weeks ago
El Cerrito, California, United States Sunbelt Staffing Full timePosition OverviewWe are seeking a dedicated Inclusion Specialist to join our team, focusing on supporting elementary students with diverse learning needs in an inclusive educational setting.Key Responsibilities:Assist elementary learners with special requirements within a collaborative classroom atmosphere.Partner with general education instructors to modify...
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Licensed Psychologist
3 weeks ago
El Monte, California, United States MRG Exams Careers Full timeAbout MRG Exams CareersMRG Exams Careers is a leading provider of independent medical exams for workers' compensation, disability, and the Veterans Administration. Our mission is to serve our veterans and help military families achieve work-life balance.Job OverviewWe are seeking a licensed psychologist to perform medical assessments on United States...
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Special Education Professional
2 weeks ago
El Monte, California, United States Mountain View School District Full timeJob SummaryUnder the direction of the Director of Student Support Services and Special Education, provides an instructional program for preschool pupils whose assessments demonstrate to the IEP Team that the degree of the pupil's impairment requires special education in one or more of the program options as authorized by Section 56361 of the Education...
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Early Intervention Specialist
7 days ago
El Cerrito, California, United States Sevita Full timeAbout the RoleWe are seeking a dedicated and compassionate Early Intervention Specialist to join our team of professionals who provide in-home early intervention services for infants and toddlers with developmental disabilities.Key Responsibilities:Plan, schedule, and provide weekly early educational in-home services for a caseload of infant/toddlers with...
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Early Intervention Specialist
2 days ago
El Cerrito, California, United States Sevita Full timeEarly Intervention SpecialistRaising a child with a developmental disability requires a unique blend of knowledge, love, patience, and support. At Sevita, we're committed to providing in-home early intervention services that empower families to help their children thrive.Key Responsibilities:Plan and provide weekly early educational in-home services for a...