Credentialing Specialist
Location:
Cerritos , California
Posted:
November 18, 2017
Reference:
00291-9500901657

A large healthcare organization in the Cerritos is in need of a Credentialing Specialist with strong knowledge of the NCQA guidelines.The Credentialing Specialist is responsible for providing credentialing and credentialing support to the medical providers at the health plan and contracted provider network through the processing of applications and reapplications to ensure that only qualified practitioners provide care within the network facilities. Provides credentialing support to the centralized appointment and reappointment process including reports and obtaining required data in accordance with the National Commission on Quality Assurance (NCQA) and The Joint Commission. Main day to day duties would be: •Provide credentialing support to the credentialing manager. •Maintain a sound working knowledge of credentialing trends and changes. •Provide consultation to the medical staff regarding credentialing matters. •Ensure all processes are in compliance with state statutes and regulatory agencies as demonstrated by observation. •Complete physician applications for the state medical licenses and hospital privileges. •Work closely with the state licensing boards and hospital medical staff offices. •Help keep physician credentials up to date, administer tracking, and reminder system. •Filing, data entry, and database maintenance. If you are interested please submit your resume to: Vanessa.Brown@roberthalf.com


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