Credentialing Specialist Job at True Vine Concepts LLC, Los Angeles, CA

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  • True Vine Concepts LLC
  • Los Angeles, CA

Job Description

Credentialing Specialist

Salary: $20 to $27 depending on experience.


Job Description:

The Credentialing Specialist will be responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process.

  • Liaise between the practitioners, health plans, hospitals, patient care facilities, and all related entities regarding credentialing, malpractice coverage, and practitioner enrollment.
  • Manage credentialing and re-credentialing processes along with completing applications for respective Commercial, Medicaid, and Medicare healthcare plans; contacting doctors for additional documentation if required; monitoring applications for timely approval and follow-up as needed.
  • Management of CAQH applications including completion and updates. Maintains provider information in online credentialing databases and systems.
  • Responsible for all necessary updates including, but not limited to address changes, NPI updates, etc.
  • Ensures facility addresses and provider information are current with health plans, agencies, and other entities.
  • Coordinate, compile, and prepare reports pertaining to doctors as requested. Preparation of correspondence associated with the credentialing process.
  • Maintains knowledge of current health plans and agencies' requirements for credentialing doctors.
  • Tracks license and certification expirations for all practitioners to ensure timely renewals. Follow-up with practitioners regarding expiring documents to ensure compliance.
  • Performs other duties as assigned.


Company Description:

To provide personalized, comprehensive care by integrating traditional wisdom with modern medical practices, ensuring each patient receives tailored treatments that address their unique physical, mental, and spiritual needs.

Address:
Priority Family Care Center

2423 N. Broadway
LA CA 90031

Industry: 
Healthcare.

Job Tags

Full time,

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