A busy healthcare organization is looking to hire a Credentialing Associate to support their corporate office in Sacramento. This is an onsite contract to hire opportunity with a progressive organization who specializes in connecting people with support resources and access to healthcare. The Credentialing Associate maintains information in provider credentialing files, coordinates, and monitors the re-credential process and ensures compliance with statues and laws relating to credentialing. Pay: $19-$25/hour DOE.

RESPONSIBILITIES:

• Gather credentials and re-credentialing materials for contracted providers.
• Review and analyze practitioner applications and reapplications, and accompanying documents, ensuring practitioner eligibility.
• Identify issues that require additional investigation and evaluation, validate discrepancies, and ensure appropriate follow up.
• Prepare credentials file for completion and presentation. 
• Respond to inquiries from other healthcare organizations.
• Assist with managed care delegated credentialing audits; conduct internal file audits.
• Monitor the initial process for all Medical/Professional staff and delegated providers. 
• Ensure compliance with rules, regulations, policies, procedures, and delegated contracts.
• Perform related duties as assigned. 

QUALIFICATIONS:

• High School Diploma or GED required. A college degree in a related field is preferred.
• 2+ years’ experience with medical administration required. 
• Experience with verifying credentials and processing new applications preferred.
• High volume data entry experience is required.
• IntelliSoft system experience preferred.
• Experience with Medi-Cal preferred.
• Strong attention to detail, focused and able to work in a fast-paced environment.
• Excellent communication skills, both verbal and written.
• Ability to solve mid-level problems with minimal supervision.
• Ability to demonstrate professionalism, confidence, and sincerity while quickly and positively engaging providers.
• Proficiency with Microsoft Office (Word, Excel, PowerPoint). 
• Ability to maintain strict confidentiality.