Pacific ExecSearch
Credentialing Specialist
Pacific ExecSearch, Sacramento, California, United States, 95828
Job Description
We are recruiting for a
Credentialing Specialist
to support a busy healthcare organization in their corporate office in Sacramento. This is an onsite contract to hire opportunity with a progressive organization who specializes in connecting people with support resources and access to healthcare. The Credentialing Associate maintains information in provider credentialing files, coordinates, and monitors the re-credential process and ensures compliance with statues and laws relating to credentialing. Pay: $24-$29/hour DOE.
The ideal candidate will have two years of medical administrative experience verifying provider credentials, accurate and heavy data entry experience and working knowledge of Medi-Cal insurance.
RESPONSIBILITIES:Gather credentials and re-credentialing materials for contracted providers.Review and analyze practitioner applications and reapplications, and accompanying documents, ensuring practitioner eligibility.Identify issues that require additional investigation and evaluation, validate discrepancies, and ensure appropriate follow up.Prepare credentials file for completion and presentation.Respond to inquiries from other healthcare organizations.Assist with managed care delegated credentialing audits; conduct internal file audits.Monitor the initial process for all Medical/Professional staff and delegated providers.Ensure compliance with rules, regulations, policies, procedures, and delegated contracts.Perform related duties as assigned.QUALIFICATIONS:
High School Diploma or GED required. A college degree in a related field is preferred.2+ years' experience with medical administration required.Experience with verifying credentials and processing new applications preferred.High volume data entry experience is required.IntelliSoft system experience preferred.Experience with Medi-Cal preferred.Strong attention to detail, focused and able to work in a fast-paced environment.Excellent communication skills, both verbal and written.Ability to solve mid-level problems with minimal supervision.Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers.Proficiency with Microsoft Office (Word, Excel, PowerPoint).Ability to maintain strict confidentiality.
Meet Your Recruiter
Karleen Rocheleau
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We are recruiting for a
Credentialing Specialist
to support a busy healthcare organization in their corporate office in Sacramento. This is an onsite contract to hire opportunity with a progressive organization who specializes in connecting people with support resources and access to healthcare. The Credentialing Associate maintains information in provider credentialing files, coordinates, and monitors the re-credential process and ensures compliance with statues and laws relating to credentialing. Pay: $24-$29/hour DOE.
The ideal candidate will have two years of medical administrative experience verifying provider credentials, accurate and heavy data entry experience and working knowledge of Medi-Cal insurance.
RESPONSIBILITIES:Gather credentials and re-credentialing materials for contracted providers.Review and analyze practitioner applications and reapplications, and accompanying documents, ensuring practitioner eligibility.Identify issues that require additional investigation and evaluation, validate discrepancies, and ensure appropriate follow up.Prepare credentials file for completion and presentation.Respond to inquiries from other healthcare organizations.Assist with managed care delegated credentialing audits; conduct internal file audits.Monitor the initial process for all Medical/Professional staff and delegated providers.Ensure compliance with rules, regulations, policies, procedures, and delegated contracts.Perform related duties as assigned.QUALIFICATIONS:
High School Diploma or GED required. A college degree in a related field is preferred.2+ years' experience with medical administration required.Experience with verifying credentials and processing new applications preferred.High volume data entry experience is required.IntelliSoft system experience preferred.Experience with Medi-Cal preferred.Strong attention to detail, focused and able to work in a fast-paced environment.Excellent communication skills, both verbal and written.Ability to solve mid-level problems with minimal supervision.Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers.Proficiency with Microsoft Office (Word, Excel, PowerPoint).Ability to maintain strict confidentiality.
Meet Your Recruiter
Karleen Rocheleau
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