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Ensure the provider's credentials comply with requirements of contracted payers and well as preparing providers files for the credentialing committee according to NCQA regulations. The Credentialing Onboarding Specialist reports to the Credentialing and Enrollment Manager and will be a key member of the Revenue Support Team. This role is primarily focused on ensuring the timely, accurate and efficient new provider onboarding and electronic billing support for all Benevis dentists and offices with payors.
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Certifications through NAMSS, AAPC NCQA, or other nationally recognized credentialing association is desired. Current systems used Cactus, Spok, CDS Desktop Fax, knowledge of credentialing platform is desired.
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Work with Senior leadership to support certification and accreditation processes with National Committee for Quality Assurance (NCQA)Serve as an expert in the administration and maintenance of credentialing and provider data management systems, including the Council for Affordable Quality Healthcare (CAQH), Credentialing System and proprietary claim systems.
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Ensures compliance and adherence to NCQA standards of function and responsibility relates to credentialing for CHP. Coordinates provider CHP packets and receipt of credentialing files from Med Staff Services.
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The Credentialing Coordinator is responsible for processing and completing the credentialing and re-credentialing functions of all providers by NCQA, state, and federal requirements.
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CREDENTIALING - Provide direction to the medical staff credentialing process and education process to ensure compliance with HIPPA, medical staff bylaws, TJC, CMS, and NCQA and other regulatory standards and initiatives.
$42.76 - $66.22 an hourFull-timeExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Collaborate with Provider Relations staff for timely completion of audits and provider profiles for re-credentialing purposes Qualifications: Graduate of accredited school of nursing, RN, 2 years of experience in quality management monitoring activities and/or credentialing/ recredentialing reviews.
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Advanced knowledge of National Practitioner Data Bank (NPDB), NCQA, TJC, CMS and State Laws and regulations as they pertain to credentialing, Provider enrollment, and Peer Review. Exercises independent judgement in interpreting NPDB, NCQA, TJC, CMS and State Laws and regulations as they pertain to credentialing.
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Incumbents will be skilled in all aspects of initial comprehensive credentialing, recredentialing, performance monitoring, in accordance with NCQA accreditation standards, state and federal regulatory requirements, and Sante's credentialing policies and procedures.
$25 - $32.5 an hourExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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The Credentialing Supervisor is responsible for ensuring the accuracy and integrity of the Credentialing processes in compliance with quality policies and procedures (e.g. NCQA), monitoring and tracking trends to limit errors.
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PMHNP should be: Legally licensed to practice medicine in Oregon State; license and DEA certificate in good standing; ability to meet necessary privileging and credentialing criteria (JCAHO and NCQA.
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Handles the duties and operations of the medical staff office, ensuring compliance with standards set by the Joint Commission, NCQA, and other accrediting bodies related to medical staff services.
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Participates in NCQA accreditation and regulatory audit preparedness activities including preparing reports, narratives, graphs, charts, etc., updating policies and procedures, and / or participating in program committees.
Starting at $49,430.25 - $107,098.87 a week depends on education, experienceFull-timeRemoteExpandApply NowActive JobUpdated 5 days ago - UpvoteDownvoteShare Job
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Serves as a resource for regulatory requirements for CMS, The Joint Commission and NCQA for delegated credentialing standards. Position Summary / Career Interest:Coordinates the credentialing and onboarding of physicians and allied health providers for professional staff membership and health system privileges.
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Evaluate and process credentialing for appointment of practitioners and follow credentialing standards of National Commission of Quality Assurance (NCQA) and The Joint Commission Standards, managed care requirements.
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