Credentialing Specialist in San Diego, CA at APEX Systems

Date Posted: 2/14/2020

Job Snapshot

Job Description

Job #:  1048924
Responsible for primary source verification of new applicants, and processing reappointment files for all practitioners and allied health providers for health system-wide. Maintains accurate updated database and hard files.
Maintains processes, which meet The Joint Commission, Title 22, CDPH, CMS, IMQ, AAAHC and NCQA standards and time frames.
Provides quality oversight and analysis of all applications processed.
Insures Credentialing documents are current and accurate.
The Credentialing Specialist has the responsibility for timely and accurate reporting and presenting of medical staff metrics to Senior Leadership. Serves as system wide super- user and technical expert for Medical Staff
Administrative IS systems. May travel to facilities, attend Credentialing/Board meetings, and work closely with Medical Staff Coordinators and Managers.
Must maintain knowledge of facility-specific Medical Staff Bylaws for entire system,
and Rules and Regulations, as they relate to the credentialing process.
Creates necessary forms and reports related to processing appointment and reappointment applications.
Experience/Specialized Skills: Minimum of 3 years medical staff administration and/or credentialing experience, preferably in a high volume, fast-paced environment.
Ability to work with customers effectively in a sensitive and confidential environment.
Effective verbal and written skills. Experienced computer user with knowledge of database systems,
Access highly desirable, word processing, and spreadsheet programs.
Ability to design and generate reports and compose letters.
Highly organized has the ability to set priorities and work independently.
Excellent interpersonal skills, able to promote and maintain a flexible, positive, cooperative attitude.
Experience providing service to customers, has a positive attitude with all customers.
High attention to detail and the ability to research and resolve problems.
Demonstrated ability to quickly and effectively handle multiple priorities and assignments to meet deadlines while maintaining professional composure.
Required Certification/Registration: Must be eligible to sit for the Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Staff Management (CPMSM) certification test.
Must be certified in either CPCS or CPMSM within 3 years of employment.
Required Education/Course(s)/Training: Bachelors required, but will consider extensive experience in field. Additional training in database management and design desirable.
EEO Employer
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178.