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Provider Credentialing Specialist
San Rafael, CA
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
- 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.
- 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!