Credentialing Assistant

Posted 4 weeks ago

Starting Pay: D.O.E

Location: City Heights

Hours of Work: TBD

Status/Hours: Full-Time/Non-Exempt

Summary:

The Credentialing Assistant assists the Credentialing Coordinator in all aspects of licensing and credentialing for providers.

Responsibilities:

• Assists in maintaining and tracking credentialing roster, employee physical
examination and vaccine roster, and supervising physician agreements
• Assists with new provider application including National Provider Identifier
(NPI), National Practitioner Databank (NPDB), The Drug Enforcement Administration (DEA), The
Office of Inspector General (OIG), Provider Enrollment, Chain and Ownership System (PECOS)
• Assists with credentialing of health plans and database including Sharp,
Sharp Community Medical Group, Multicultural Medical group, Aetna, Aetna better health,
Molina Healthcare, Care 1st, Community Health Group, and Council for Affordable Quality Healthcare
(CAQH)
• Assists with applications for credentialing of dental plans including: Delta Dental,
United Health Care, United Concordia, Cypress PPO, Cigna, Carington, Liberty Insurance, First
Dental, Met Life, Humana, Premier Access, Principal, HealthNet DHMO
• Responds to emails, faxes and answers incoming calls regarding provider credentials.
• May travel to clinic sites for delivery or pick-up of physician/hospital
documents and signatures.
• Ensures that provider files and records are maintained in accordance with legal
requirements and company policies and procedures.
• Following the credentialing checklists; the collection of required items/documents
from providers and other sources are performed in a timely manner.
• Assist with the preparation of new applications / pre-applications clinical
privileges.
• As instructed, completes revisions of applications including the collection of
pending credentialing documents.
• Handles with urgency any inquiries regarding provider’s credential status
• Works diligently with colleagues to ensure the accuracy of all files by tracking the
expiration of licenses and certifications.
• Assumes responsibility for establishing and maintaining effective communication,
coordination, and working relations with Company personnel and with management.

Skills:

• Credentialing experience preferred, but not required.
• Office equipment (phone, fax, etc.) and computer proficiency necessary, including
Microsoft Office (Outlook, Word, Excel, PowerPoint) and Adobe.
• Must be able to learn quickly and work with minimal supervision.
• Ability to effectively prioritize and execute tasks in a high-volume,
high-pressure environment.
• Strong customer service orientation and focus.
• Must be reliable and possess extreme attention to detail and documentation.
• Excellent interpersonal and communication skills, both oral and written.

Interested Applicants please submit Cover Letter and Resume down below or to:

Human Resources Department

Email: employment@lamaestra.org

Fax: 619-269-1291

La Maestra Community Health Centers is an equal opportunity employer and does not
discriminate on the basis of race, religion, color, sex, national origin, age, sexual orientation, gender, disability or any other legally protected status.

Job Features

EducationHigh school diploma or equivalent. Bachelor’s Degree Preferred.
Certification/Licensure:Certified Provider Credentialing Specialist (CPCS) preferred.

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