Credentialing Specialist

  • location: Redwood City, CA
  • type: Contract
  • salary: $30 per hour
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job description

Credentialing Specialist

job summary:
This is a great opportunity to work for a world class healthcare company that truly values its employees, customers and community.

I am seeking a strong Credentialing Specialist in Redwood City, CA.

Job Description:

  • Initiates the credentialing protocol as well as and processes data in compliance with Federal, State, Program, and Regional requirements.
  • Ensures thorough and timely verification of physicians credentials according to regional Credentialing Policies and Procedures.
  • Acts as liaison between medical centers and medical offices credentials and privileges coordinators and the regional office.
location: Redwood City, California
job type: Contract
work hours: 9 to 5
education: Associate's degree
experience: 3 Years
Essential Functions:

  • Ensures consistent documentation and complete verification of physicians' credentials.
  • Provides required documentation to appropriate physician's managers and committees in the practice sites.
  • Processes all credentials applications and/or applications for employment with TPMG.
  • Initiates extensive investigation into the applicants background, education and experience through the use of on-line systems, written correspondence, telephone inquiries and printed reference guides and reports.
  • Partners with the practice site Credentials & Privileges Coordinators to ensure an integrated, timely, consistent product.
  • Collaborates with professional physician recruiters to monitor recruitment status of candidates to ensure timely credentialing prior to employment.
  • Develops and maintains a computerized data base of physician data for use in the credentialing and appointment process.
  • Maintains files of current Scopes of Practice for all specialties, Professional Staff by-laws for all medical center and current Federal, State, Program and Regional requirements.
  • Implements efficient and effective combinations systems for transmission of credentials information to practice sites to facilitate timely approval to participate and professional staff appointment.
  • Keeps abreast of changes in laws and regulatory requirements.
  • Writes and implements new procedures as necessary to remain in compliance.
  • Works with practice site Credentials and Privileges Coordinators to share and implement best practices whenever feasible
Minimum Work Experience and Qualifications

  • Minimum three (3) years of experience with credentialing in a hospital or medical setting.
Preferred Work Experience and Qualifications

  • Experience with Med Staff or Medical Information Data Analysis System preferred.
  • Certification as Certified Provider Credentialing Specialist (CPCS) preferred.

  • Associate's degree required. Bachelor's degree preferred.
  • Shift Required: Monday - Friday 9am to 5:30pm.
  • Duration: 2 month contract that could extend further.
  • Pay Rate: $30.00 per hour.
Additional Preferred Requirements:

  • Proficient with IBM PC, dBase, WordPerfect and Lotus 1-2-3.
  • Proficient with Medical Terminology.
  • Significant knowledge of Federal and State regulatory requirements and accreditation standards e.g., The Joint Commission, TITLE 22, NCQA, NPDB, and certifying agencies.
  • Strong organization and communication skills and attention to details required.
  • Proven ability to function independently with minimal direct supervision.
If you feel like you are a match for this position, please reply to this email with your updated resume attached and the best time for a short, 20 minute conversation today. If you don't feel this job is a good fit for you, but you know of someone else who may have these qualifications, please forward them this email and send me their name and contact number.

skills: Decision Support
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

Qualified applicants in San Francisco with criminal histories will be considered for employment in accordance with the San Francisco Fair Chance Ordinance.

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance.

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