Credentialing Specialist

Company: Family Health Centers of San Diego
Location: San Diego
Posted on: October 16, 2024

Job Description:

Impact Lives, Impact CommunityFamily Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 62 sites, over 227,000 patients, and over 417,000 visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff.General Job DescriptionThe Medical Staff Coordinator processes and maintains all necessary Provider and Medical Staff credentialing, privileging, and health plan enrollments.Job Roles* Coordinates credentialing and privileging for all Licensed Independent Practitioners per FHCSD policies, Joint Commission, NCQA and health plan requirements.* Maintains and utilizes MD Staff software to track/maintain LIP credentialing and privileging information.* Maintains signed mid-level agreements with applicable providers.* Performs other duties as assigned.* Prepares agendas, minutes and communications for Clinical Review Committee.* Processes and follows-up on individual and group applications for affiliated hospitals, health plans and government programs.* Processes renewal applications of DEAs & Licenses for providers as requested.* Provides reports and copies of credentials, forms, letters etc., as requested for audits and credentialing to FHCSD management, affiliated hospitals, health plans and government programs.* Tracks and processes provider CME allowance request, including check requests for payment or reimbursement.Education/Certifications/Licenses/Registrations* 3 years of comprehensive credentialing experience preferred.* 3-5 years experience in an administrative support role required. Experience in Human Resources department preferred.* Ability and means to travel as needed in a timely manner within San Diego County. DRIVER REQUIREMENTS: Requires an active Class C California driver's license, proof of liability insurance at $100,000, on vehicle used. No more than 2 points in past 12 months; No suspensions in last 2 years for moving violations; No DUI, reckless or felony Driving within 5 years. No license revocation in 7 years.* Certified Medical Staff Coordinator or Certified Provider Credentialing Specialist preferred.* High school diploma or GED equivalent required. College coursework preferred.* Or equivalent combination of education and experience that provides the skills, knowledge and ability to perform the essential job duties, and which meets any required state or federal certification requirements.Experience/Specialized skills (including Language)* Ability to touch type 55 wpm and have excellent grammar, spelling and punctuation skills.* Ability to work independently; possess problem solving and demonstrates creative thinking skills.* Bilingual (English/Spanish) preferred.* Demonstrated ability to maintain good working relationships with employees, coworkers, and departments.* Exceptional interpersonal and customer service skills.* Exceptional oral and written communications skills.* Exceptional organizational skills, attention to detail, time-management skills, and strong motivation to meet deadlines and achieve goals.* Intermediate skills in computer applications and software, including MS Office.* Knowledge of medical terminology preferred.* Knowledge of provider and independent practitioner credentialing and privileging.Physical Requirements/Working EnvironmentBending (neck): OCCASIONALLY (1 - 3 HRS)Bending (waist): RARELY (0-1 HRS)Carrying 0 - 10 lbs: OCCASIONALLY (1 - 3 HRS)Carrying 11 - 25 lbs: RARELY (0-1 HRS)Carrying 25 - 50 lbs: NEVERCarrying 51 - 75 lbs: NEVERCarrying 75 lbs: NEVERClimbing (ladder): NEVERClimbing (stairs): RARELY (0-1 HRS)Driving: To drive from one clinic or another, or in the community: INCIDENTAL DRIVING (LESS THAN 3 DAYS/WEEK)Exposure to blood borne pathogens and biohazards: NOExposure to dust, gas, fumes, or chemicals: OFFICE SUPPLIESFine manipulation: FREQUENTLY (3 - 6 HRS)Kneeling: NEVERLifting 0 - 10 lbs: OCCASIONALLY (1 - 3 HRS)Lifting 11 - 25 lbs: RARELY (0-1 HRS)Lifting 25 - 50 lbs: NEVERLifting 51 - 75 lbs: NEVERLifting over 75 lbs: NEVERPower Grasping: RARELY (0-1 HRS)Pulling 0 - 10 lbs: OCCASIONALLY (1 - 3 HRS)Pulling 11 - 25 lbs: RARELY (0-1 HRS)Pulling 25 - 50 lbs: NEVERPulling 51 - 75 lbs: NEVERPulling over 75 lbs: NEVERPushing 0 - 10 lbs: OCCASIONALLY (1 - 3 HRS)Pushing 11 - 25 lbs: RARELY (0-1 HRS)Pushing 25 - 50 lbs: NEVERPushing 51 - 75 lbs: NEVERPushing over 75 lbs: NEVERReaching (above shoulder level): RARELY (0-1 HRS)Reaching (below shoulder level): RARELY (0-1 HRS)Repetitive use of hand: CONSTANTLY (6+ HRS)Simple Grasping: FREQUENTLY (3 - 6 HRS)Sitting: CONSTANTLY (6+ HRS)Standing: RARELY (0-1 HRS)Twisting: NEVERUse of Personal Protective Equipment: NOWalking: RARELY (0-1 HRS)Working around equipment and machinery: Office equipment.Ages of Patients Served: N/AIn the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits or potential bonuses.25.74 - 36.81If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and/or experience. In addition to these factors - we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here:

Keywords: Family Health Centers of San Diego, El Centro , Credentialing Specialist, Other , San Diego, California