Credentialing Coordinator I

Position Summary:

• Credential all new providers, Re-credential existing Providers according to Regal Medical Group credentialing policies and procedures.
• Submit credentialing information as requested by contracted HMOs.
• Maintain and update files on all credentialed Providers.
• Provide credentialing information on a Provider when requested by other RMG
• Maintain and update Provider files in credentialing database.

Essential Duties and Responsibilities include the following:

• Process Provider applications to RMG Credentialing Plan and NCQA specifications.
• Process Ancillary applications to RMG Credentialing Plan and NCQA specifications.
• Assist with the gathering of information required to complete credentialing/re-credentialing cycles for providers of Regal Medical Group
• Data entry for credentialing database with current information.
• Prepare and review practitioner files for Credentialing Committee review and decisions.
• Assist Management in training and teaching Credentialing Assistants in their assigned tasks.
• Perform all other duties as assigned by Management.

The pay range for this position at commencement of employment is expected to be between $21-23 per hour; however, base pay offered may vary depending on multiple individualized factors, including market location, job-related knowledge, licensure, skills, and experience.

The total compensation package for this position may also include other elements, including a sign-on bonus and discretionary awards in addition to a full range of medical, financial, and/or other benefits (including 401(k) eligibility and various paid time off benefits, such as vacation, sick time, and parental leave), dependent on the position offered.

Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

If hired, employee will be in an “at-will position” and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time, including for reasons related to individual performance, Company or individual department/team performance, and market factors.

As one of the fastest growing Independent Physician Associations in Southern California, Regal Medical Group, Lakeside Community Healthcare & Affiliated Doctors of Orange County, offers a fast-paced, exciting, welcoming and supportive work environment. Opportunities abound, and enterprising, capable, focused people prosper with us. We promote teamwork, nurture learning, and encourage advancement for all of our employees. We want to see you excel, because we believe that your success is our success.

Full Time Position Benefits:

The success of any company depends on its employees. For us, employee satisfaction is crucial not only to the well-being of our organization, but also to the health and wellness of our members. As such, we are firmly dedicated to providing our employees the options and resources necessary for building security and maintaining a healthy balance between work and life.

Our dedication to our staff is evident in our comprehensive benefits package. We offer a very generous mixture of benefits, including many employer-paid options.

Health and Wellness:

• Employer-paid comprehensive medical, pharmacy, and dental for employees
• Vision insurance
• Zero co-payments for employed physician office visits
• Flexible Spending Account (FSA)
• Employer-Paid Life Insurance
• Employee Assistance Program (EAP)
• Behavioral Health Services

Savings and Retirement:

• 401k Retirement Savings Plan
• Income Protection Insurance

Other Benefits:

• Vacation Time
• Company celebrations
• Employee Assistance Program
• Employee Referral Bonus
• Tuition Reimbursement
• License Renewal CEU Cost Reimbursement Program
• Business-casual working environment
• Sick days
• Paid holidays
• Mileage

Employer will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of the LA City Fair Chance Initiative for Hiring Ordinance.

Education and / or Experience:

• High School graduate or equivalent.
• One year or more of experience with credentialing.
• Good written and verbal communication skills.
• Knowledge of Windows-based computer skills preferred.
• Proficient in Microsoft Excel.
• Attention to detail.
• Ability to work well under pressure.
• Well organized.