Top 2 Credentialing specialist remote Jobs in Valencia, Ca

HDO Credentialing Coordinator
MedPOINT Management —Sherman Oaks, CA
- $28 - $31 an hour
- Microsoft Excel
- Writing skills
- Mid-level
Risk Management and Contract Compliance Specialist
The Village Family Services —North Hollywood, CA
- $32.69 - $36.05 an hour
- 8 hour shift
- Hybrid work
- Computer Science
- Research
- Mid-level
- 403(b) matching
- Health insurance
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HDO Credentialing Coordinator

MedPOINT Management -
Sherman Oaks, CA

Apply Now

Job Details

$28 - $31 an hour

Qualifications

High school diploma or GED
Hospital experience

Full Job Description

Summary

Responsible for collaborating with CVO, credentialing staff and provider services to coordinate, monitor and maintain the credentialing and re-credentialing process for Health Delivery Organizations (HDO).

Duties and Responsibilities:

Coordinates all activities related to network credentialing including, but not limited to application completeness and maintenance for HDOs.
Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up.
Ensures that all facilities meet standards related to quality improvement programs and personnel issues.
Verifies that providers are accredited by an appropriate accrediting agency before submission for HDO credentialing process and every three years thereafter.
Oversees preparation of HDO credential files for completion and presentation to MedPOINT’s Credentialing Committee.
Responds to inquiries from health plans and facility staff; interfaces with internal and external clients on day-to-day credentialing issues as they arise.
Optimizes efficiencies with document generation and reporting.
Participates in MPM Credentialing Committee meetings (monthly and ad hoc).
Collects and verifies quarterly provider rosters from HDOs.
Assists with P & P development in accordance with NCQA guidelines for HDO credentialing.
Contributes information to any corrective action plans related to HDOs.
Assists with non-HDO credentialing functions as requested by leadership as time permits.
Performs miscellaneous job-related duties as assigned and requested.

Minimum Job Requirements:

High school diploma or GED
At least 2 years’ experience with hospital medical staff or managed care credentialing including HDO processing
NAMSS Certification as a Certified Professional Medical Services Manager (CPMSM) or Certified Provider Credentials Specialist (CPCS) or actively pursuing the above certification highly preferred

Skills and Abilities:

Strong written and oral communication skills
Excellent presentation and analytical skills
Ability to multitask and work well as a team
Ability to work independently and productively in a remote environment
Ability to analyze, interpret and prepare reports
Proficiency with Microsoft Office 365 Programs; primarily Word and Excel
EZ-CAP® knowledge a plus.

Salary Range:

$28 – $31 hourly

Apply Now

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credentialing specialist remote jobs in valencia, ca

HDO Credentialing Coordinator

Risk Management and Contract Compliance Specialist

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