Credentialing Specialist
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Job Location:
Palm Springs, CA - USA
Hourly Salary:
$ 25 - 28
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Department:
Job Summary
Job Details
Description
At DAP Health we are committed to transforming lives and advancing health equity for all. As a leading nonprofit health care provider we deliver compassionate high-quality care to the diverse communities of the Coachella Valley and San Diego County. Our comprehensive services range from primary care to mental health wellness programs and beyond with a focus on those who are most vulnerable. Joining our team means becoming part of a passionate innovative organization dedicated to making a meaningful impact in the lives of those we serve. If youre looking for a dynamic and purpose-driven environment we invite you to explore the opportunity to contribute to our mission.
Job Summary
The Credentialing Specialist plays a critical role in maintaining the integrity and regulatorycompliance of our healthcare workforce. This position is responsible for managing credentialingoperations for all licensed clinical staff ensuring adherence to internal policies regulatorystandards and Federal Tort Claims Act (FTCA) requirements. Key responsibilities includeverifying and maintaining accurate up-to-date credentialing documentation for all clinicians. TheCredentialing Specialist also ensures that practitioners are properly credentialed and privilegedin alignment with FTCA deeming guidelines HRSA expectations and applicable federal andstate regulations.
Supervisory Responsibilities: NoneLocation: Must be located in Southern CA
Essential Duties/Responsibilities
Credentialing Operations
- Conduct and oversee initial and re-credentialing activities for all licensed personnel
- Review credentialing applications and supporting documentation for accuracy andcompleteness
- Serve as the primary point of contact for internal and external inquiries regardingcredentialing status providing timely updates and requested information
- Maintain an update the credentialing database to ensure all records are accurate andcurrent
- Monitor and report upcoming expirations of licenses board certifications and other time sensitive credentials
- Apply standardized credentialing and privileging procedures consistently across alllicensed staff
- Identify and escalate credentialing concerns or red flags to appropriate managers anddirectors
- Assist in processing and distributing incoming correspondence related to credentialingactivities
Primary Source Verification
- Demonstrate working knowledge of state federal and accreditation standards related tocredentialing and privileging
- Compile and review data on sanctions complaints and adverse actions associated withapplicants
- Investigate discrepancies or adverse findings independently and validate informationfrom applications and verification sources
- Communicate findings and recommended actions to relevant stakeholders
Credentialing Committee Support
- Prepare documentation and materials for credentialing and privileging committee review
- Shared responsibility for facilitating committee meetings and presenting applicantinformation
- Collaborate with internal departments to ensure credentialing activities align withorganizational compliance requirements
Qualifications
Required Skills/Abilities
- Knowledge of healthcare regulations including those related to Medicare Medicaid andcommercial insurance plans
- Strong organizational and communication skills
- Attention to detail and ability to manage multiple tasks simultaneously
- Proficient in Microsoft Office Suite
Education and Experience
- 3-5 years of experience in clinical primary source verification
- Credential for Provider Credentialing Specialist (CPCS) certificate desired but notrequired
- Experience working with credential software such as MD Staff a plus
Working Conditions/Physical Requirements
- This position is fully remote and is based out of the Southern California area
- This job operates in a home office setting and requires frequent times of sittingstanding repetitive motion and talking.
- Ability to lift up to 50 pounds and move from place to place
- Ensures compliance with policies and procedures related to safe work practices
Required Experience:
IC
Key Skills
- Sales Experience
- Crane
- Customer Service
- Communication skills
- Heavy Equipment Operation
- Microsoft Word
- Case Management
- OSHA
- Team Management
- Catheterization
- Microsoft Outlook Calendar
- EHS
