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Provider Credentialing Specialist

San Rafael, CA

Position: Healthcare

Job Description

The Credentialing Specialist is responsible for credentialing individual, facility and/or ancillary medical/surgical providers to ensure all credentialing standards and internal requirements are met and maintained.

- Pay: $25 - $40 per hour

- Work schedule: M-F, either 8-430pm, 730-4, or a 9am start time

Job Responsibilities:

  • Verifies and maintains all network, individual and/or facility/ancillary providers’ information.
  • Monitors disciplinary actions, and follows up accordingly.
  • Corresponds with licensing board, hospitals, certification agencies, training programs and medical groups to resolve any issues. Ensures and maintains overall accuracy of the credentialing database.
  • Gathers data, builds/runs reports and sends out updates.
  • Corresponds with the licensing board, hospitals, certification agencies, training programs and medical groups, practitioners, office staff, provider network administrators, contracting and management to resolve issues.
  • May review and identify credentialing or re-credentialing practitioners, including verifications of correspondence, data entry, etc., in accordance with company policies and procedures.
  • Reviews and analyzes reports, policies and procedures, summarizes, analyzes and makes notations in reports for feedback to groups and for distribution to management and Credentialing Committee.
  • Assists in the preparation of file reports and binders for monthly Credentialing Committee meetings, including pre-and post-Committee functions.
  • Assists on internal projects to obtain follow-up information as requested by the Credentialing Committee or Peer Review Teams.

Education/Experience:

  • High school diploma. Associate’s degree in Business Administration, Health Care Administration or related field preferred.
  • At least two years of related experience

PLEASE APPLY TO BE CONSIDERED!

Meet Your Recruiter

Alana Klingman
Strategic Accounts Recruiting Manager

Alana is a native Huntington Beach resident making the move to Sacramento just a few years ago. She comes with over 15 years of experience in full cycle healthcare recruiting and thoroughly enjoys every aspect of her job. Receiving a new client order and placing a qualified applicant is truly an excitement each and every time. Her goal at the end of every day is to leave a positive impression with everyone she works with including letting the candidates know that she is on their side. She strives to fill every client need that comes across her desk with a candidate that can call that place of business HOME. When she is not hard at work Recruiting, Alana spends her free time attending local family events, trying new eateries and perfecting DIY home projects she found on Pinterest.

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