Credentialing Coordinator - **Strong Experience in Credentialing for a Large Agency Preferred

**Schedule Mon - Fri 8:30am - 5:00pm. CPCS or CPMSM certification from National Association Medical Staff Services Preferred. Ideal candidate will possess strong experience in credentialing for a large agency. **

Hourly Pay range is $30 to $40 depending on the relevant years of experience. 

We offer a competitive package of employee benefits for 30 to 40-hour week positions. You will receive a defined contribution amount of up to $14,580 per year (prorated for part-time employees working less than 40 hours per week) to purchase the benefits of your choice on a cafeteria plan basis. Any amount of this defined contribution not used towards your benefits will be paid to you as taxable earnings. We offer a retirement plan with a generous employer match starting at 4% after one year of employment.  Our paid time off is also more generous than many employers with vacation time accruing up to 25 days per year, 6 days of sick time per year and 12 paid holidays.

The benefits offered in our cafeteria plan are as follows: 

• Medical benefits –Kaiser--ranging from $0 Deductible Plan with $15 Copay to $,3200 Deductible Plan with Health Savings Account. Sutter Health plans are also available from $0 Deductible Plan to $2,500 Deductible Plan.
• Dental benefits –Guardian: 1 dental HMO and 2 PPOs 
• Vision benefits – 2 options from Guardian VSP: a standard vision plan and an   
  enhanced vision plan

PRINCIPAL DUTIES AND RESPONSIBILITIES:

1. Credentialing Process Oversight: *
   • Assist staff with the credentialing process by verifying and tracking credentials.
   • Search and print National Provider Identifier (NPI) forms, ensuring the taxonomy codes align with the staff’s role.
   • Monitor and maintain credentialing files for compliance with applicable regulations.
2. Licensing and Certification Requirements: *
   • Stay updated on the latest medical licensing and certification requirements to ensure compliance for all relevant staff.
3. Audit and Documentation: *
   • Audit paperwork, including applications and licensing documentation, for accuracy and completeness.
   • Assess providers’ qualifications relative to established standards
   • Ensure that all required documentation for onboarding is collected and filed appropriately.
4. Collaboration and Reporting: *
   • Work with the Reimbursement Department to ensure credentialing issues do not impact the invoicing process.
   • Produce monthly reports for BHSD Santa Clara County.
   • Track and enter data into the AVATAR system, including annual TB testing for the SUTS program.
   • Track and update department managers to ensure timely and accurate credentialing of clinical staff.
5. Credentialing and Re-credentialing Management: *
   • Manage the credentialing and re-credentialing process for providers, ensuring all necessary documentation is submitted and up to date.
   • Prepare and submit credentialing applications and supporting documentation for review and approval.
   • Monitor and track expirable documents or licenses, following up with providers to obtain updated copies.
   • Maintain various databases and spreadsheets related to credentialing.
6. Administrative Support for Quality Improvement:
   • Provide general administrative support to the QI Department, including drafting correspondence and creating forms as needed.
   • Collaborate with QI team members on policies, procedures, guidelines, and manuals to support compliance initiatives.
7. Training and Development: *
   • Attend community, agency, team training meetings, and events to stay informed about industry standards and regulations.

KNOWLEDGE, SKILLS AND ABILITIES: (Essential = E / Desired = D)

1. Education and Experience:
   • Associate’s degree or graduation from a recognized business school with a degree in business or related discipline, plus a minimum of two years’ progressively responsible administrative support or office management experience; (E) additional experience may be substituted for the preferred degree on a year-to-year basis. (E)
2. Certifications:
   • Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification from the National Association Medical Staff Services (NAMSS). (D)
3. Technical Skills:
   • Proven typing speed of 40 net wpm; (E) 50 net wpm. (D)
   • Proficient in MS Office applications (Word, Excel, Outlook) and Windows-based databases. (E)
4. Communication and Customer Service:
   • Strong written and verbal communication skills, including appropriate English grammar, spelling, and punctuation. Ability to proof and edit both own and others' work. (E)
   • Ability to exhibit exemplary customer service, compassion, and care in all duties and interactions. (E)
5. Task Management:
   • Ability to multitask in an interrupt-driven environment, maintaining timelines and deadlines. (E)
   • Strong organizational skills, with the ability to work independently and manage multiple priorities. (E)
   • Ability to troubleshoot, resolve issues, and escalate when necessary. (E)
6. Confidentiality and Professionalism:
   • Demonstrated ability to maintain confidentiality of sensitive information. (E)
7. Adaptability and Teamwork:
   • Ability to adapt to changing systems, methods, and environments. (E)
   • Ability to work effectively with persons of diverse backgrounds and abilities. (E)
8. Other Requirements:
   • Physical requirements to perform the essential functions of the job, with or without accommodation:
     • Hearing and talking on the telephone and in person; standing, walking, sitting, pinching, and finger flexion required constantly (over 2/3 of the workday).
     • Lifting, carrying, pushing, pulling, bending, stooping, crouching, and kneeling occasionally (under 1/3 of the workday). (E)

Salary : $30 - $40