Credentialing Specialist - El Monte, CA
Compensation: $68,000 - $85,000 per year DOE
Overview: Nexus HR is looking for a Credentialing Specialist in , CA. The ideal candidate will be responsible for overseeing and managing the credentialing processes for healthcare professionals within the organization.
About the Job
The Credentialing Specialist will help maintain providers’ compliance to legal regulations and accreditation. They will serve as the bridge that facilitates credentialing needs for the clinic’s medical providers and the organizing/credentialing/accrediting organizations. The Credentialing Specialist will be involved in the application and the maintenance of the credentialing of all medical providers as well as managing medical records and files.
Duties and Responsibilities:
Create and maintain files of all medical providers, form physicians to mid-level providers, to medical assistants, both hard and soft copies.
Create and maintain files for credentialing applications and renewals.
Process and track new applications and renewal applications for all medical providers.
Coordinate with billing and management to monitor and resolve any denials or any issues with authorization related to provider credentials.
Maintain a provider database and other important credentialing records.
Keep up to date with the latest credentialing legislation and industry standards.
Manage medical records and files
All other tasks assigned.
Qualifications :
At least high school diploma or GED equivalent
2 years of experience in credentialing or comparable work experience
1 year of experience working in the healthcare industry
Familiarity with California credentialing statutes and regulations
Strong knowledge of credentialing process and procedures
Familiarity with EHR/EMR softwares
Excellent customer service towards colleagues and providers.
Able to work in El Monte, CA
Authorized to work in the US
Benefits:
Dental
Vision
Medical
401k
Paid Leave
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