Enterprise Credentialing Specialist: Enterprise Credentialing
About The Position
Description Primary Duties And Responsibilities Maintain regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations. Create and carry out credentialing processes for physicians, other healthcare professionals, and sites. Assist the Supervisor in ensuring that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws. Process applications and reappointment paperwork, verifying completeness and accuracy. Collect and process significant amounts of verification and accreditation information. Maintain and update accurate databases for practitioners and facilities, including education, training, experience, and licensure information. Prepare records for regular auditing. Maintain close communication with practitioners to ensure records are up to date and consistent. Demonstrate behaviors consistent with core values and comply with all required standards. Qualifications Education and Experience High School diploma, GED, California High Proficiency or equivalent work experience Proficiency with Microsoft Office Products (Word, Excel, PowerPoint) Experience specific to NCQA standards preferred MD Staff experience preferred Proficiency with medical terminology preferred License Required: N/A License Preferred: N/A Certifications Required N/A Certifications Preferred Certified Professional Credentialing Analyst (CPCS) Certified Professional Medical Services Professional (CPMSM)
Requirements
- High School diploma, GED, California High Proficiency or equivalent work experience
- Proficiency with Microsoft Office Products (Word, Excel, PowerPoint)
Nice To Haves
- Experience specific to NCQA standards preferred
- MD Staff experience preferred
- Proficiency with medical terminology preferred
- Certified Professional Credentialing Analyst (CPCS)
- Certified Professional Medical Services Professional (CPMSM)
Responsibilities
- Maintain regular cooperation and compliance with all regulatory, accrediting, and membership-based organizations.
- Create and carry out credentialing processes for physicians, other healthcare professionals, and sites.
- Assist the Supervisor in ensuring that all personnel and services adhere to facility and staff policies, department guidelines, regulations, and government laws.
- Process applications and reappointment paperwork, verifying completeness and accuracy.
- Collect and process significant amounts of verification and accreditation information.
- Maintain and update accurate databases for practitioners and facilities, including education, training, experience, and licensure information.
- Prepare records for regular auditing.
- Maintain close communication with practitioners to ensure records are up to date and consistent.
- Demonstrate behaviors consistent with core values and comply with all required standards.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
