Medical Staff Credentialing Specialist jobs in Irvine, CA

Medical Staff Credentialing Specialist processes credentialing and recredentialing applications for health care providers. Mails, reviews, and verifies credentialing applications. Being a Medical Staff Credentialing Specialist sets up and maintains provider information in an online credentialing database system. Tracks license and certification expirations for all providers to ensure timely renewals. Additionally, Medical Staff Credentialing Specialist may require an associate degree or equivalent. May require certification as a Certified Provider Credentialing Specialist (CPCS). Typically reports to a supervisor or manager. The Medical Staff Credentialing Specialist works under moderate supervision. Gaining or has attained full proficiency in a specific area of discipline. To be a Medical Staff Credentialing Specialist typically requires 1-3 years of related experience. (Copyright 2024 Salary.com)

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Credentialing Specialist
  • ABC Home Medical Supply, Inc.
  • Irvine, CA FULL_TIME
  • The Credentialing Specialist is responsible for assisting in all aspects of the licensing and credentialing of the Company. The Specialist will process applications on behalf of the Company in order to ensure compliance and completeness of licenses and agreements with Medicare, state Medicaid agencies, federal, state and local licensing agencies and private health insurance companies.


    ESSENTIAL DUTIES AND RESPONSIBILITIES:

    Include the following as well as other duties and responsibilities, which may be assigned.


    • Assist with the maintenance of complete and accurate documentation regarding the Company, its facilities/operations, its ownership and its management to ensure proper and complete completion of licensing and credentialing applications and insurance agreements;
    • Assist with timely responses to requests for information from federal, state and local agencies and private insurance companies regarding the Company’s licensing and credentialing obligations;
    • Assist with research, maintenance and coordination of all federal, state and local licensing requirements
    • Accurate and timely completion of initial, renewal applications as well as process organizational changes via notification and/or application;
    • Assist with the maintenance of the Company database to ensure accuracy of all licenses and agreements with federal, state and local organizations and private health insurers
    • Assist with the completion of all revalidation or re-credentialing requests from Medicare, state Medicaid agencies and private health insurance companies;
    • Prepare all licensing and applications for new locations of the Company in order to obtain Medicare licensing, state licensing and accreditation
    • Contact insurance companies to initiate participation into their DME provider networks, including the completion of letters of interest and applications,
    • Maintain the Company’s database of Provider Insurance contracts,
    • Notify all pertinent Company personnel regarding new insurance contracts, fee schedules, and updating the Company’s Payer database
    • Other duties as assigned


    QUALIFICATIONS:

    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily and must possess the ability to: interact professionally and ethically with team members, all levels of management, government agencies and commercial payer personal; handle multiple tasks simultaneously; provide clear, concise oral and written directives/communications; quickly assess situations and respond appropriately; handle special requests in a sensitive, professional manner. Strong attention to detail and follow through is required. Meticulous organization and filing skills. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


    QUALIFICATION REQUIREMENTS:

    To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.


    EDUCATION AND/OR EXPERIENCE:

    • High School Diploma
    • Associate or Bachelor’s degree, or relevant healthcare experience
    • Analytical skills required, attention to detail, organized


    TRAINING:

    Our industry is a highly regulated industry, and because of that and our commitment to providing the best in class products, services, and support, we require ALL employees to complete the following training programs prior to the marketing and promotion of our products, services, and support systems:


    • Anti-Kick Back Training
    • Fraud, Abuse, and Waste Training
    • HIPAA Training
    • Systems Training


    CONTINUING EDUCATION:

    To continue to be best in class within our industry, we require all employees to participate in ongoing education to maintain / increase their competency or in the event the team member changes responsibility within the company.


    Notice:

    Employment with the Company is “at will.” This means a team member or the Company may end a team member’s employment at any time with or without reason. None of the Company’s policies, procedures, or practices, including those set forth on the Company Website and/or Intranet, are to be viewed as creating any promises or contractual rights. They are guidelines that the Company may, at its discretion, change at any time without prior notice to any team member. The information contained in this policy replaces all previous handbooks and other statements of Company policies, rules, and procedures.

  • 8 Days Ago

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Credentialing Specialist
  • Smile Brands Inc.
  • Irvine, CA FULL_TIME
  • Smile Brands, a three-time Glassdoor Best Place to Work, is seeking a Credentialing Specialist to join our team! This position provides dental plan credentialing, enrollment and related support to the...
  • 18 Days Ago

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Credentialing Specialist
  • Smile Brands
  • Costa Mesa, CA OTHER
  • Overview Smile Brands is a dominant player in the dental space and we are seeking a Credentialing specialist to join our team. In this role your focus and responsibilities include maintaining and veri...
  • 1 Month Ago

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Credentialing & Contracting Coordinator
  • Matics Medical Office Services
  • Orange, CA FULL_TIME
  • Matics Medical Office Services provides comprehensive billing services for behavioral health practices across the United States, including psychotherapy, psychiatry, ABA, and chemical health. Our goal...
  • 1 Day Ago

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Medical Staff Coordinator
  • Saddleback Memorial Medical Center
  • Laguna Hills, CA FULL_TIME
  • Medical Staff Coordinator - (SAD005440) Description Title: Medical Staff Coordinator Location: Laguna Hills, CA Department: Status: Part-Time Shift: Days (8hr) Pay Range*: $33.11/hr - $48.04/hr At Mem...
  • 1 Day Ago

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Travel MA - Medical Assistant
  • Focus Staff Services
  • Newport, CA PART_TIME
  • OverviewWe currently have a client in Newport Beach, CA looking for Medical Assistant!Focus Staff is seeking a Medical Assistant who is highly motivated and energetic.Contract Assignment – 13 Weeks (T...
  • 12 Days Ago

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0 Medical Staff Credentialing Specialist jobs found in Irvine, CA area

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Per Diem (PRN) Cath Lab Tech job in Fullerton, CA - Make $682/shift
  • Aya Healthcare
  • Fullerton, CA
  • Job DescriptionYoure one step away from freedom and flexibility around your current schedule. We have immediate per diem...
  • 3/28/2024 12:00:00 AM

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Summer Lifeguard
  • Premier Aquatics
  • Newport Beach, CA
  • NO EXPERIENCE NEEDED PART-TIME/HOURLY TEAM MEMBERS ELIGIBLE FOR RAISE AFTER EVERY 60 SHIFTS COMPENSATION $17-$20/hr Seas...
  • 3/27/2024 12:00:00 AM

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Quality Control Inspector (2nd Shift)
  • Pathway Group
  • Costa Mesa, CA
  • Job Description Job Description Job Description: We are seeking a new Quality Control Inspector. Your role will be to pe...
  • 3/27/2024 12:00:00 AM

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School-Based Mental Health Counselor (Various Locations,CA- Remote)
  • Anchor Counseling & Education Solutions, LLC
  • Orange County, CA
  • Job Description Job Description Description Work. Care. Help. Live With Purpose If you thrive in a fast-paced, goal-orie...
  • 3/27/2024 12:00:00 AM

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PT Mental Health Clinician - Fluent in Spanish - Faith Based Private P
  • Florecer Therapy Family Marriage An
  • Los Angeles, CA
  • Job Description Job Description Mental Health Counselor Job Opportunity in California for Associates and Licensed Clinic...
  • 3/26/2024 12:00:00 AM

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Credentialing Specialist
  • Mitchell Martin Inc.
  • Los Angeles, CA
  • Job Duties: • The Credentialing Specialist II is responsible for managing their workload, addressing all functions for i...
  • 3/25/2024 12:00:00 AM

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Electrical Engineer | SOLAR | Public Sector
  • Wentworth Executive Recruiting
  • Los Angeles, CA
  • Job Description Job Description ELECTRICAL ENGINEER | RENEWABLE ENERGY I SOCAL Our client is a leading provider of turnk...
  • 3/25/2024 12:00:00 AM

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Travel Nurse RN - Home Health Wound Care - $2,900 per week
  • TRS Healthcare
  • Costa Mesa, CA
  • LanceSoft is seeking a travel nurse RN Home Health Wound Care for a travel nursing job in Costa Mesa, California. Job De...
  • 3/25/2024 12:00:00 AM

Irvine (/ˈɜːrvaɪn/) is a master-planned city in Orange County, California, United States in the Los Angeles metropolitan area. The Irvine Company started developing the area in the 1960s and the city was formally incorporated on December 28, 1971. The 66-square-mile (170 km2) city had a population of 212,375 as of the 2010 census; in 2018 the California Department of Finance estimated the city's population at 276,176. A number of corporations, particularly in the technology and semiconductor sectors, have their national or international headquarters in Irvine. Irvine is also home to several hi...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Staff Credentialing Specialist jobs
$45,850 to $58,061
Irvine, California area prices
were up 3.0% from a year ago

Medical Staff Credentialing Specialist in Shreveport, LA
The University of Kentucky is committed to a diverse and inclusive workforce by ensuring all our students, faculty, and staff work in an environment of openness and acceptance.
December 08, 2019
This position will review credentialing/privileging information for accuracy and primary source verify all information in accordance all regulatory agencies and University of Kentucky policies and procedures.
December 06, 2019
Medical Staff Credentialing Specialist in Brownsville, TX
In addition, the Medical Staff Services Facility Specialist provides information and guidance regarding medical staff bylaws, medical staff ruled and regulations, allied health professionals (AHP) policies, Joint Commission for Accreditations of Healthcare Organizations (JCAHO) and Center for Medicare and Medicaid Services (CMS) and other regulatory agencies as they pertain to medical staff and allied health professionals.
December 05, 2019
Medical Staff Credentialing Specialist in Cincinnati, OH
Under minimal supervision coordinates, monitors and maintains the credentialing and re-credentialing process for the Medical Staff and Allied Health Professionals.
February 13, 2020