RESPONSIBILITIES:Kforce has a client in search of a Credentialing Specialist in Long Beach, California (CA).
You will be responsible for coordinating all aspects of the credentialing and primary source verification process for practitioners and health delivery organizations according to the company policy and procedures.
- Process initial and recredentialing applications from providers, meeting departmental requirements
- Complete data entry of applications, reviewing them for errors prior to turning in the provider files for quality review, meeting departmental requirements
- Process the minimum number of provider applications each month, meeting departmental requirements
- Prepare and send out recredentialing groups, meeting departmental requirements
- Complete 1st, 2nd and 3rd requests for recredentialing packets, meeting departmental requirements
- Send report to various state plans/departments to identify any providers who haven't returned their recredentialing applications or who are past-due for credentialing, meeting departmental requirements
Ongoing Monitoring/Watch Follow-up Specialist:
- Complete follow-up for provider files on watch status, meeting departmental requirements
- Ensure that follow-up occurs for the ongoing state license action monitoring reports, meeting departmental requirements
- Ensure that follow-up occurs for the ongoing Medicare/Medicaid sanctions monitoring reports, meeting departmental requirements
- Maintain the minimum volume of delegated provider entered into CACTUS to ensure expected levels of productivity, meeting departmental requirements
Day to day responsibilities:
- eviewing credentialing applications to submit for processing, answering phone, answering questions in emails, updating database, sending approval letters, and various other tasks
- High School diploma or equivalent
- Required Licensure/Certification: Certified Provider Credentialing Specialist (CPCS) or, participation in a CPCS progression program
- 0 - 2 years of relevant experience
- 1 year of credentialing experience; high speed internet to work from home
- This is a remote opportunity
Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.