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Description
Position: Credentialing Specialist
-Hybrid: Remote & In-office (as needed)
This position reports to the Director of Provider Services and is responsible for full cycle credentialing of Providers and Facilities. Position must have experience with facility credentialing of Hospitals, SNF, Home Health, Radiology etc. The role will work closely with new client implementation and will assist regularly with transitioning Credentialing file of new clients moving from one MSO to another. This position requires strong organization skills, attention to detail, able to identify issues and recommend solutions. Implementation will require thorough auditing of already approved files to ensure system data matches file and reviewing files for errors that will impact Health Plan audit. The Specialist will have oversite to ensure Provider Rosters can be pulled, Re-credentialing timeframe are met and CAQH accounts are setup and maintained. Credentialing Specialist will assist in preparing files for pre-delegation and annual audits, monitoring of providers and entities. This position will also work closely with Quality and will require some travel when Facility Site Reviews are required.
Some Major Duties Include:
Position
Pay
IMS offers competitive compensation. We are an equal opportunity employer and seek diversity in our workforce.
Our Company
Our team at IMS is looking for highly motivated and resourceful individuals to join our growing start-up. We strive to innovate the healthcare industry by providing management and consulting services to healthcare entities, including healthcare facilities, medical groups, providers, and suppliers. Using our wide-ranging experience and comprehensive knowledge of the healthcare industry, our team works to provide quality services and customer care to our clients and their Medicare beneficiaries. By working at IMS, you’ll gain an in-depth perspective of the managed care industry and share in the professional development of our expanding company. Take initiative and ownership of your projects to make a difference and go the extra mile! We welcome you to apply to join our team!
Requirements
Education
Certifications/Licenses
Experience
Knowledge/Skills/Abilities/Other Attributes
*Please note that the duties and responsibilities outlined above are summarized and may not encompass all tasks associated with the position. The nature of the role may require adaptation to changing circumstances and additional responsibilities not explicitly mentioned here. The organization reserves the right to modify, interpret, or supplement the job duties as needed.
Full Time
$45k-57k (estimate)
09/24/2022
05/07/2024
imsmso.com
Los Angeles, CA
The job skills required for Credentialing Specialist include Customer Service, Managed Care, Initiative, Quality Assurance, etc. Having related job skills and expertise will give you an advantage when applying to be a Credentialing Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Credentialing Specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Credentialing Specialist positions, which can be used as a reference in future career path planning. As a Credentialing Specialist, it can be promoted into senior positions as a Compliance Manager - Healthcare that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Credentialing Specialist. You can explore the career advancement for a Credentialing Specialist below and select your interested title to get hiring information.
If you are interested in becoming a Credentialing Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Credentialing Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Credentialing Specialist job description and responsibilities
A certified professional credentialing specialist ensures that staff members of a facility maintain licenses, training, and certifications based on federal and state law.
03/14/2022: Des Moines, IA
A credentialing specialist can have certificates that will prove useful to their field.
02/01/2022: Newark, NJ
Credentialing specialists also ensure that any services provided by medical facilities meet the required standards as set by state and federal government agencies.
02/21/2022: Evansville, IN
Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures.
02/01/2022: Las Cruces, NM
Credentialing specialists will also ensure that their employer meets state, federal and other regulations for quality of care.
01/18/2022: Pueblo, CO
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Credentialing Specialist jobs
Credentialing specialists can often find work with a high school diploma or the equivalent.
01/25/2022: Kingsport, TN
Some employers strongly prefer credentialing specialists who have a Certified Provider Credentialing Specialist (CPCS) credential.
03/01/2022: Parkersburg, WV
While an associate degree may not be required for a position as a credentialing specialist, some employers may prefer applicants with a two-year degree.
12/25/2021: Little Rock, AR
Make Use Of Advanced Software For Monitoring.
01/18/2022: New London, CT
Stay Updated with the Coalition for Affordable Quality Healthcare's Credentialing Program.
01/31/2022: Portsmouth, OH
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