Credentialing & Audit Specialist
Credentialing & Audit Specialist
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Job Description
Job Title:Credentialing & Audit Specialist
Department:Human Resources
Location:Ukiah CA
Status:One (1) Full-Time Non-Exempt
Hours:40 hours per week
Salary:$25.20$28.30 per hour (DOE) / Additional Differentials Must Qualify
Open Date:May 21 2025
Close Date:Open Until Filled
Pay Differentials Offered (must qualify through testing or verification):
- Language Translation Bi-cultural Spanish:$1.00/hour
- Bimodal Bilingualism ASL (American Sign Language):$1.00/hour
- Bimodal Multilingualism ASL and another language:$2.00/hour
Overview:
The Credentialing/Audit Specialist will be responsible for submitting tracking and responding to internal customers counties and individual provider credentialing and contracting. Experience preferred in credentialing and auditing and that has worked in a preferably Behavioral Health or Medical Healthcare environment. The candidate will have a deep knowledge and history of working through electronic health records and protocols and will have hands on experience with submitting application tracking progress and working with clinical staff to gather the information needed for both group and individual credentialing.
Additionally responsible for a variety of support activities in the operation of the functions of pre-onboarding and the agency Recruiter or Senior level staff. Prepares issues electronically tracks and follows-up on appropriate work-related verifications for efficient high-volume processing of individual applications in accordance with applicable County and Cal-AIM credentialing standards established procedural guidelines and strict timelines. This position partners with HR team members to ensure compliance.
Key Responsibilities:
- Maintain compliance with all regulatory and accrediting institutions
- Monitor all staff credentials and licenses.
- Advise staff on renewal procedures.
- Participate in the development of internal credentialing processes.
- Keep records in licenses credentials and insurance contracts.
- Oversees all internal audits within the Human Resources Department.
Education &/or Experience:
Bachelors degree in human resources or related field and three (3) years of direct experience working in an administrative role in a highly generalized human resources department or Certification in Human Resource Management or an Associates degree in administration or business or six (6) years of direct experience as a confidential position and/or human relations related field in a mid-sized company of the six (6) years - two (2) years of experience providing administrative support to medical and/or management staff in a healthcare/behavioral health environment which must include a minimum of one (1) year experience directly related to medical staff credentialing.
Conditions of Employment:
- Valid California Drivers License current auto insurance and a clean DMV record (no more than 3 points).
- Successful completion of background checks with DOJ FBI CACI and CCL.
- Completion of TB test and physical examination at time of employment.
Training Provided:
Comprehensive onboarding including:
- CPR / First Aid
- Crisis Communication / Pro-ACT
- Trauma-Informed Care
- Motivational Interviewing
- Collaborative Problem Solving
Benefits:
Redwood Community Services offers a full benefits package.
More information available at: Apply:
Please visit our website atRedwood Community Servicesto apply or learn more about our values and services.
Redwood Community Services Inc. is an Equal Opportunity Employer and is committed to fostering an inclusive and diverse workplace.
Required Experience:
Senior IC
Employment Type
Full-Time
