FOLSOM SURGERY CENTER is seeking a Full-time CREDENTIALING SPECIALIST.

The credentialing specialist is responsible for all aspects of the credentialing and re-credentialing process of facility/ancillary providers including medical providers. The credentialing specialist is responsible for ensuring providers are credentialed with governmental entities, health plans, and any other payers as necessary. They will maintain up-to-date data for credentialing databases and online systems, and will ensure timely renewal of revalidations, licenses, and certifications. This position will cover two centers. Location of centers: Roseville and Folsom. 

 JOB DUTIES INCLUDE, BUT ARE NOT LIMITED TO:

• Complete ancillary and provider credentialing and re-credentialing applications for CMS, State Medicaid any and all commercial plans; monitor applications and follows-up as needed
• Ensure practice addresses are current with health plans, agencies and other entities
• Maintain all contracting, credentialing, and provider files in an organized and track-able system
• Managed all necessary internal credentialing information in a secure and accessible file/database
• Maintain knowledge of current health plan and agency requirements (e.g. CMS, State Medicaid, CAQH) for credentialing
• Special projects as required for Managed Care team to support strategic reimbursement efforts
• Track license and certification expirations for all ancillary and physician providers to ensure timely renewals

Required Skills

QUALIFICATIONS:

• 2+ YEARS OF PREVIOUS CREDENTIALING EXPERIENCE PREFERRED
• Knowledge of Licensing, accrediting, CMS, and third party payer requirements
• Proficient in working with Microsoft Office, specifically MS Excel
• Strong oral and written communication skills

PREFERRED SKILLS

• Ability to analyze and interpret data and solve practical problems
• Must be able to handle a wide work variety and work in a fast paced environment
• Must be detail oriented, organized, self-starter, and have an ability to prioritize workload

USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce.  If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.  If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law. 

Required Experience

QUALIFICATIONS:

• 2+ YEARS OF PREVIOUS CREDENTIALING EXPERIENCE PREFERRED
• Knowledge of Licensing, accrediting, CMS, and third party payer requirements
• Proficient in working with Microsoft Office, specifically MS Excel
• Strong oral and written communication skills

PREFERRED SKILLS

• Ability to analyze and interpret data and solve practical problems
• Must be able to handle a wide work variety and work in a fast paced environment
• Must be detail oriented, organized, self-starter, and have an ability to prioritize workload

USPI complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce.  If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.  If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.