Credentialing Specialist

The Credentialing Specialist is responsible for all aspects of the credentialing, recredentialing and privileging processes for all medical providers who provide patient care. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans and hospitals. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.

ESSENTIAL DUTIES AND RESPONSIBILITIES
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and recredentialing applications; monitors applications and follows-up as needed.
- Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing
documents for all providers.
- Maintains knowledge of current health plan and agency requirements for credentialing providers.
- Sets up and maintains provider information in credentialing database.
- Tracks license and certification expirations for all providers and clinical personnel to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
- Processes applications for appointment and reappointment of privileges to ASC.
- Tracks license, DEA and professional liability expirations for appointed ASC providers and clinical personnel.
- Maintains ASC appointment files, and information in credentialing database.
- Audits health plan directories for current and accurate provider information.

Requirements:
- Knowledge of a minimum of the first few steps of the credentialing process
- Knowledge of full payor enrollment process (REQUIRED)
- Must come from the provider side (not just insurance side)

Pay: $20-22/hr DOE (with TONS of room for pay increases/promotions)

Schedule:
Hours: start as early as 7am, and end as late as 6pm. Training will be 8:00am-5:00pm EST
**Has to be 8 hour shift, so can't start past 10am**

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.