Ambulatory Clinic Credentialing Specialist

3 weeks ago


Oceanside, California, United States Tri-City Healthcare District Full time
Job Summary

We are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at Tri-City Healthcare District. The successful candidate will be responsible for performing credentialing activities, including maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare and Medicaid.

Key Responsibilities:
  • Maintains a safe, clean working environment, including unit-based safety and infection control requirements.
  • Requests all necessary credentialing documentation from onboarding providers and maintains all current copies of credentialing documentation.
  • Completes all attestations through the various required entities.
  • Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, compliance with federal, state, and local regulations, guidelines, policies, and standards.
  • Enters, updates, and maintains data from provider applications into credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.
  • Communicates clearly with internal and external customers and provides timely responses regarding credentialing and privileging issues.
Requirements:
  • Three (3) years medical and professional credentialing experience, required.
  • Strong organizational skills, including ability to prioritize daily workload to meet multiple tasks and deadlines, required.
  • Ability to communicate effectively utilizing both written and verbal skills, required.
  • Ability to provide excellent customer service, required.
  • Ability to interpret, adapt, and apply guidelines and procedures. Knowledge of Joint Commission standards and regulatory requirements, required.
Education:
  • High-school diploma or GED, required.
  • Associate's degree, preferred.
Certification:
  • CPCS, preferred.


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