EL CAMINO HEALTH MEDICAL NETWORK IS CURRENTLY SEEKING A SKILLED TEMPORARY CREDENTIALING AND PROVIDER ENROLLMENT SPECIALIST TO JOIN OUR GROWING HEALTHCARE TEAM!

Location: Remote
Schedule: Part-time 20 hours per week
Duration: This is a temporary need through January 31, 2026 but could be extended if necessary
Compensation: $35.00-$43.00/ hourly
Silicon Valley Medical Development, (SVMD) LLC is a growing provider organization with community-based ambulatory care clinics and medical practices in Santa Clara County.
SVMD seeks to coordinate care that best fit the needs of the communities we serve, with like-minded people who want to simplify the healthcare experience. With a commitment to teamwork and quality, together we can offer exceptional care to our patients.
The Credentialing and Provider Enrollment Specialist is responsible for taking a new provider application in accordance with applicable organizational policies and procedures from receipt to inclusion in payer directories and making ongoing updates. He/she performs all assigned activities associated with initial appointments and re-appointments, ensuring compliance with the appropriate accrediting and regulatory agencies including verification, peer recommendations, and follow-up on concerns that may delay completion of the credentialing or re-credentialing processes. This involves accurate and timely entry of provider data, including provider applications and contract information, status changes, payee changes. It also includes verification of all the credentialing criteria for practitioners’ initial credentialing, re- credentialing, and following up with practitioners and payers as needed to obtain or supply information for the credentialing process and continued network participation with the payers.
Responsible for the accuracy and integrity of the credentialing database system and related applications. He/she will track and update databases to reflect current compliance with credentialing and privileging elements for enrolling individual providers and provider groups with payers.
Essential Functions:

MINIMUM REQUIREMENTS:

• High School Diploma or GED
• 2 years of college or equivalent work experience in a managed care environment (i.e., IPA or Health Plan)
• Knowledge of credentialing applications/programs
• Proficient in Microsoft Office product suite (including Outlook, Excel, Word)
• Ability to work within established guidelines and protocols
• Ability to utilize web-based resources for information retrieval purposes
• Ability to work in collaboration with all departments
• Ability to prioritize multiple projects as well as perform other duties as assigned for the department
• Knowledge of NCQA Guidelines and JCAHO to maintain certifications
• Knowledge of ICE regulations for healthcare providers
• Strong working knowledge of applicable guidelines and regulations
• Ability to accurately type a minimum of 40 WPM
• Strong verbal and written communications, and active listening skills
• Solid patient/guest relations skills with the ability to communicate in a professional, courteous and efficient manner
• Ability to perform basic math
• Excellent attention to detail
• Ability to effectively organize and prioritize task in order to complete assignments within the time allotted to maintain standard workflow
• Ability to work effectively as a team member who is flexible, cooperative and willing to assist others
  Location: Silicon Valley Medical Development · SVMD Admin
  Schedule: Part Time, Days, TB

Please refer the Job description for details