Credentialing Specialist

Responsible for full cycle credentialing of Other Clinical Staff (OCS) and Other Licensed or Certified Practitioners (OLCP). The role will ensure OCS and OLCP staff maintain current credentials and licenses to work legally in their field or specialty. The Credentialing Specialist monitors upcoming recredentialing deadline are met by collaborating with staff and management to advise them of the required steps to maintain their credentials. Review information on potential new employees to make sure all required licenses and credentials are current before hiring and internal transfers.

Reports to: HR Administration Manager

Qualifications:

1.    High School Diploma or General Educational Development (GED) certificate. Associate or bachelor’s degree in business management or related field is preferred.

2.    Minimum of three years’ experience working as a Credentialing Specialist, preferably in a Federally Qualified Health Center (FQHC) setting.

3.    Accredited Certification as a Certified Provider Credentialing Specialist (CPCS) issued by the National Association of Medical Staff Services. Complete the CPCS certification program within three months of attending training session(s), if not obtained at time of hire.

4.    A working knowledge of compliance with all regulatory and accrediting institutions for credentialing and privilege.

5.    Use critical thinking skills to conduct follow-up with individual staff, practitioners, internal and external entities to resolve discrepancies identified during the credentialing process.

6.    Thorough working knowledge of business English, spelling, punctuation, and contemporary general office practices and procedures.

7.    Math skills sufficient to prepare routine spreadsheets, calculate/balance invoices/expense reports, and similar.

8.    Proven high quality customer relationship (internal and external) skills.

9.    Demonstrated supervisory skills sufficient to supervise one to two employees.

10.    Computer skills in Microsoft Office programs (Word, Excel, etc.), and database systems.

11.    Typing and data entry skills sufficient to meet production requirements.

12.    Effective verbal and written communication skills to communicate clearly and effectively with patients and others. 

13.    Highly effective oral and written communications skills including public speaking experience.

14.    Strong attention to detail, effective work organization and time management skills. 

15.    Ability to work collaboratively.

16.    Ability to be flexible and work in a changing environment.

17.    Sensitivity to the diverse cultures represented among members and staff.

18.    Demonstrated ability to listen and communicate with others in a professional and caring manner including sensitivity with individuals from diverse cultures and lifestyles.

19.    Skilled in maintaining confidentiality and discretion regarding employee information. 

20.    Fluency in English (speaks, read, and write).

21.    Ability to adapt quickly and easily to changing situations and priorities.

22.    Current California driver’s license, appropriate insurance coverage and a driving record acceptable to the NEVHC’s insurance carrier (if required to drive on the job). 

Northeast Valley Health Corporation provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Northeast Valley Health Corporation complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities.