Credentialing Specialist, Hybrid In-Office San Marcos, CA at TrueCare

San Marcos, California, United States -

Full Time

Start Date

Immediate

Expiry Date

09 Mar, 26

Salary

32.2

Posted On

09 Dec, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Credentialing, Documentation Review, Data Entry, Primary Source Verification, Communication, Organizational Skills, Attention to Detail, Microsoft Office, MD Staff Software, CME Processing, Licensing Reimbursement, Healthcare Experience, Regulatory Compliance, Database Auditing, Report Generation, Team Collaboration

Industry

Hospitals and Health Care

Description

TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status. With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care. The Credentialing Specialist supports the Medical Staff department in ensuring that all healthcare providers are properly credentialed, privileged, and enrolled, and in compliance with federal, state, and organizational credentialing policies. Responsibilities: Collect and review initial credentialing and recredentialing applications. Ensure completeness and accuracy of documentation (licenses, certifications, malpractice insurance, etc.) Enter and update credentialed staff information in credentialing databases or software (e.g., MD-Staff, CAQH, NPPES) Verify provider credentials including education training, licensure, board certification, employment history and references. Contact licensing boards, educational institutions, and previous employers for primary source verification. Communicate with Licensed Independent Providers (LIPs), staff to obtain missing or expired documents. Track expiration dates and ensure timely renewal of licenses, DEA registrations, and other required documents. Audit credentialing databases to ensure accuracy and integrity of data. Generate and distribute credentialing reports and assist in preparing files for credentialing committee meetings. Process Continuing Medical Education (CME) requests. Process licensing reimbursement requests. Qualifications: High School Diploma or equivalent. 3 to 4 years in a clinical- healthcare setting with relevant credentialing experience. Strong organizational skills and attention to detail. Computer proficiency with web-based applications and the Microsoft Office suite, including Outlook, Word, Excel and PowerPoint. Preferred Qualifications: Associate degree in Business or Healthcare Administration. MD Staff Credentialing Software knowledge. National Association Medical Staff Services Certification (NAMSS). Certified Provider Credentialing Specialist (CPCS). Certified Professional Medical Staff Management (CPMSM). Experience in healthcare or working in a Federally Qualified Health Center. Benefits: Competitive Compensation Competitive Time Off Low-cost health, dental, vision & life insurance Tuition Reimbursement, Employee Assistance program The pay range for this role is $23 to $32.20 on an hourly basis. Pay transparency: If you are hired at TrueCare, your salary will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining an offer. TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of any characteristic protected by applicable federal, state, or local law. Our goal is to support all team members recruited or employed here.

Responsibilities

The Credentialing Specialist is responsible for collecting and reviewing credentialing applications, ensuring compliance with policies, and verifying provider credentials. They also track expiration dates and assist in preparing files for credentialing committee meetings.