Company Overview
Complete Care Community Health Center has been dedicated to providing quality healthcare services to underserved communities since 2007. Focused on community health and preventative medicine, we are committed to serving our patients with compassion and excellence.
Overview
We are seeking a detail-oriented and proactive Credentialing and Facilities Management Assistant to support our administrative operations. This role is vital in ensuring compliance with healthcare standards, managing credentialing processes, and maintaining facility readiness. The ideal candidate will possess strong organizational skills, familiarity with managed care, and experience in medical office environments.
A medical credentialing assistant is responsible for verifying the qualifications, licenses, and certifications of healthcare professionals to ensure they meet regulatory and organizational standard. This role is vital for patient safety, legal compliance, and the efficient operation of healthcare facilities and insurance networks. Key Duties and Responsibilities
- Application Management: Process initial and re-credentialing applications for physicians, nurses, medical assistants and allied health professionals, ensuring they are complete and accurate.
- Primary Source Verification (PSV): Conduct thorough verification of a provider's credentials, including education, training, state licenses, DEA certificates, board certifications, and malpractice insurance, by contacting the original sources or using specialized databases (e.g., CAQH, NPDB).
- Database Management: Maintain accurate, current, and confidential provider information in credentialing software and internal databases, tracking all relevant data and expiration dates.
- Compliance Monitoring: Ensure that all credentialing activities comply with federal and state regulations and company policies and procedures.
- Payer Enrollment: Submit completed applications and supporting documentation to various government and private insurance payers and follow up until the provider is credentialed.
- Auditing and Reporting: Assist in preparing for internal and external audits and regulatory reviews by organizing files and reports.
- Communication: Serve as a liaison between healthcare providers, internal departments (such as HR and medical staff leadership), and external agencies to resolve discrepancies or request missing information.
- Policy Development: Participate in the maintaining and implementation of internal credentialing policies and procedures.
- Facilities Management: Visit various clinic cites to ensure that the Company's Policies & Procedures are followed. Prepare reports for management.
Qualifications and Skills
- Education: A high school diploma is required, while an associate or bachelor's degree in healthcare administration, health information management, or a related field is often preferred.
- Experience: A minimum of 2 years of related experience in a medical or healthcare administration setting is preferred.
- Certification: While not always mandatory, the Certified Provider Credentialing Specialist (CPCS) certification from the is highly valued by employers and can enhance career prospects.
- Technical Skills: Proficiency with Microsoft Office Suite (Word, Excel) are essential.
- Soft Skills: Strong attention to detail, excellent organizational and time-management abilities, strong written and verbal communication skills, and the ability to handle confidential information with discretion are critical.
Pay: $30.00 - $35.00 per hour
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Work Location: In person
