Credentialing Specialist

San Diego, California 92111

Job ID: 12681 Category: Professional

 

Voca Professional has immediate openings available for Credentialing Specialist professionals in San Diego, CA!

 

Voca connects healthcare professionals with fantastic health systems nationwide. Our goal is full partnership with our employees, providing the tools, guidance, and opportunities to help reach their individual goals. Voca provides benefits including insurance, 401k, and dedicated support!

Assignment details are provided below, we’re very excited to hear from you!

 

Assignment Details 

Job Description:

  • Schedule- M-F 7a-4p Duration- 13 weeks
  • Provider Credentialing - Processing of provider credentialing & re-credentialing applications for contracted health plans and government payors. Preparation of pertinent information for the monthly Joint Quality Credentialing Committee Meetings.
  • Medi-Cal EHR Incentive/Meaningful Use - On an annual basis determine provider eligibility and subsequent completion of and provider enrollment applications.
  • Maintain updates to facility IS EMR system and credentialing database. Assist with updates to the Credentialing Database.
  • Audits - Participate in internal and external audits with health plans medical groups and State and Federal agencies. Assure policies and procedures comply with current accreditation and regulatory standards per NCQA health plan standards and other regulatory agencies as required.
  • Provider Updates and Rosters - submission of provider changes (enrollment status name changes etc) to contracted entities. Maintain current provider rosters for internal and external use.
  • EFT Enrollment - Process Electronic Funds Transfer enrollment applications with health plan payors. Provided updates as needed. Including Pay-to address updates to government payors.

 

Qualifications

  • School Education Associate's Degree (Preferred) H.S. Diploma GED or Equivalent (Minimum) Experience 3 Years of Experience (Minimum) 4 Years of Experience (Preferred)

 

Traveler Benefits

Partnering with Voca comes with a number of benefits including:

  • Dedicated Recruiter
  • Insurance
  • 401k
  • Competitive, Flexible Pay Packages


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