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Maintains knowledge of current payor, agency, and third-party requirements for credentialing providers, including, but not limited to, NCQA, URAC, and CMS standards. The Credentialing Specialist coordinates and performs a variety of duties that are required for processing applications for credentialing applicants and recredentialing existing network providers.
Full-timeExpandApply NowActive JobUpdated 16 days ago - UpvoteDownvoteShare Job
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Confirm delegated provider credentialing audits performed by the delegated credentialing team for initial, annual, and interim assessments in accordance with Joint Commission, NCQA, CMS, state and federal requirements.
Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Maintains correspondence files and credentialing archival files. Knowledge of NCQA and/or JCAHO Accreditation standards. Maintains and updates credentialing database, inclusive of demographic and licensure information.
RemoteExpandUpdated 8 days ago - UpvoteDownvoteShare Job
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Performs other credentialing duties as requested. One year Credentialing experience preferred. Maintains and updates continuing medical education/ACLS credits and other training requirements.
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Licensure, Certification & Registration:Certified Professional in Medical Staff Management (CPMSM)ORCertified Provider Credentialing Specialist (CPCS) preferredORAchievement of certification (CPMSM/CPCS) within 24 months of becoming eligible.
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Skilled in computer applications including MS Word, MS Excel, database administration and scanning applications. US Anesthesia Partners, Inc. provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, gender identity, sexual orientation, pregnancy, status as a parent, national origin, age, disability (physical or mental), family medical history or genetic information, political affiliation, military service, or other non-merit based factors.
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Must possess sufficient eye-hand coordination/manual dexterity to operate a keyboard, photocopier, telephone, calculator and other office equipment. Processes initial applications and reappointments for hospitals, surgical centers and managed care entities for assigned divisions.
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Involves frequent contact with professional staff and managed care organizations. AS or B.S. degree in business administration or health care related field is a plus. Knowledgeable in Federal and State Regulation on Confidentiality; and Peer Review Guidelines.
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Processes providers applications for privileges and reappointments and monitors licensure renewal activity for Physicians, CRNAs, APNs, and PAs. disclaimer: The above job description has been written to indicate the general nature and level of work performed by employees within this classification.
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Requires dexterity to type at least 35 wpm. Required normal range of hearing and eyesight to record, prepare, and communicate appropriate reports and evaluations. Maintains and updates curriculum vitae/profiles for each provider.
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Certified Provider Credentialing Specialist (CPCS) certification preferred. Essential Duties & Responsibilities:The essential duties of the Credentialing Specialist include but are not limited to the following activities: Responsible for all credentialing processes related to compliance, regulations and billable services.
$60,000Full-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Monitors renewals of licensure and forwards copies of licensure to facilities as renewals are received. Requires lifting papers and boxes weighing up to 35 pounds occasionally. Requires prolonged sitting, some bending, stooping and stretching.
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It is not written to be inclusive of all duties, responsibilities and qualifications required of employees assigned to this job. Ability to work independently with limited supervision. Maintains complete file of providers licensure and credentials.
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Well versed in the use of the Cactus Database CPCS (Certified Provider Credentialing Specialist) Knowledge of Cactus a plus Knowledge or experience with credentialing processes desirable.
$27 - $30 an hourFull-timeExpandApply NowActive JobUpdated 2 days ago - UpvoteDownvoteShare Job
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Knowledge of organizations policies, procedures and systems. Maintains accurate records of providers credentials. Skilled in verbal and written communications. High School graduate or equivalent. Adhere to all company policies and procedures.
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ncqa credentialing specialist jobs
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