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Credentialing Specialist

GLIA HEALTH MANAGEMENT LLC

Credentialing Specialist

San Marcos, CA
Full Time
Paid
  • Responsibilities

    The Neuron Clinic is a busy outpatient neurology practice with locations in Chula Vista, Temecula, and San Marcos, CA. We are passionate about delivering high-quality patient care that is science based. We are the fastest growing neurology group in Southern California with growing opportunities for career and leadership development.

    We are seeking a healthcare professional that is passionate about quality care and making a difference in our patients lives.

    Why Join the Team?

    Competitive Compensation

    Generous Health Insurance Coverage: Medical & Dental

    Retirement Plan - Dollar for Dollar match

    Paid Vacation Accruals

    Paid Holidays

    Work alongside extremely talented highly specialized doctors

    Excellent Work-life Balance

    Summary

    Credentialing Specialists obtains, verifies, and analyzes all information on medical staff applicants for membership and privileges, and for reappointment. They ensure that applications new and existing are completed and reviewed to meet compliance regulations. Credentialing Specialist ensures provider credentialing with health plans. Credentialing Specialists often work independently. This requires the employee to be able to manage their workload effectively to meet set deadlines.

    Essential Duties and Responsibilities

    Maintain compliance with all regulatory and accrediting institutions

    Assess volume of applications to strategize production for timely outcomes

    Facilitate communication with internal and external parties to properly update any needs

    Participate in the development of internal credentialing processes

    Keep accurate and compliant records in licensing, credentials, and insurance contracts

    Preferred Education and Experience

    Demonstrated knowledge of credentialing principles, credentialing requirements/regulations related to an outpatient care facility

    1 year of experience in Healthcare, credentialing area preferred

    Cert Provider Credential Spec (CPCS) or Cert Pro Medical Services Management (CPMSM) certificationMedical assisting education or other related education either in progress or completed, highly preferred

    Special Conditions of Employment

    Furnish proof of COVID-19 vaccination

    Knowledge Skills and Abilities

    Self-motivated and desire to learn and grow in healthcare

    Strong attention to detail

    Excellent analytical and critical thinking skills

    Excellent verbal and written communication skills and the ability to communicate effectively with patients, providers and payors

    The ability to prioritize and multitask efficiently and effectively

    Strong commitment to actively supporting an ethical working environment

    Strong knowledge of computer-based systems such as Excel, Word, and the Internet with the ability to quickly learn new systems.

    Ability to compose, proofread and edit documents for accuracy

    Bilingual English/Spanish preferred

    Schedule

    8 hour shift

    Monday - Friday