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Credentialing Coordinator

Washington Health Medical Group
  • Fremont, CA
  • Full-time
5 days ago

Job Description

Summary/Objective
Reporting to the Director of Human Resources and Administrative Services provides support to the Washington Township Medical Foundation Credentialing Department.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Process initial credentialing and re-credentialing applications for physicians, NPs and Pas
  • Verify licenses, certifications, education, work history, and malpractice coverage through Healthguard for primary source verification
  • Maintain credentialing databases (e.g., CAQH, payer portals) and ensure timely updates
  • Track expiration dates for licenses, DEA registrations, and certifications; proactively follow up to prevent lapses
  • Maintain Rosters
  • Administrator for Payors, including, but not limited to: granting/removing employee access, password resets, etc.
  • Prepare credentialing files for internal committee review and payer submission
  • Communicate with providers to collect required documentation
  • Ensure compliance with NCQH and state/federal regulations
  • Respond to inquiries from health plans, hospitals, and internal stakeholders regarding provider   status
  • Maintain confidentiality of sensitive provider information
  • Back up to the Executive Assistant/Manager of Administration.
  • Other duties as assigned.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.
Qualifications and Education Requirements
  • Must have at least 6 months to a year of related credentialing experience.
  • Proficiency in Microsoft Office Suite
  • Must have strong organizational skills to effectively prioritize, coordinate, perform and complete multiple duties and assignments concurrently and in a timely manner.
  • Must have the ability to communicate effectively and handle sensitive/confidential information.
  • Knowledge of and proficiency in English composition, spelling, grammar, punctuation, and basic math principles.
Competencies
  • Business Acumen
  • Interpersonal Relationships
  • Change Agent
  • Collaboration Skills
  • Communication Proficiency
  • Decision Making
  • Initiative
  • Leadership
  • Problem Solving/Analysis

Job Type: Full-time

Salary: $29.00-$35.00 per hour

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Employee assistance program
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Parental leave
  • Vision insurance

Schedule:

  • Monday to Friday

Work Location: One location

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Numbers & Facts

LocationFremont, CA
Job TypeFull-time
Websitehttps://www.washingtonhealth.com/

Skills

  • Administrative Managementunmatched
  • Administrative Skillsunmatched
  • Business Skillsunmatched
  • Communication Skillsunmatched
  • Database Administrationunmatched
  • Dental Insuranceunmatched
  • Documentationunmatched
  • Employee Assistance Planunmatched
  • English Languageunmatched
  • Establish Prioritiesunmatched
  • Executive Assistant Skills unmatched
  • Health Planunmatched
  • Hospitalunmatched
  • Human Resourcesunmatched
  • Interpersonal Skillsunmatched
  • Leadershipunmatched
  • Mathematicsunmatched
  • Microsoft Officeunmatched
  • Multitaskingunmatched
  • Organizational Skillsunmatched
  • Physical Demandsunmatched
  • Problem Solving Skillsunmatched
  • Team Playerunmatched
  • Time Managementunmatched
  • United States Drug Enforcement Agency (DEA)unmatched

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