Job Openings in Sacramento County and Beyond

Credentialing Associate

SACRAMENTO, CA 95831

Posted: 02/19/2024 Employment Type: Contract Industry: Healthcare Job Number: 1673532

Job Description

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. 

Meet Your Recruiter

Karleen Rocheleau

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