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A healthcare organization is moving quickly, to identify a detail-driven professional to support provider readiness, compliance, and credentialing workflows. This role manages the full lifecycle of provider and clinic staff credentialing, recredentialing, and privileging, ensuring alignment with California regulations, HRSA FTCA, NCQA, and Joint Commission standards. This is a high-impact, time-sensitive need supporting leadership and clinical teams where accuracy and compliance are critical. The Credentialing Specialist compiles and maintains the full lifecycle of provider and clinic staff credentialing, recredentialing, and privileging for all licensed, certified and other clinical staff. Manages workflows, ensures data accuracy, and collaborates with leadership, providers, and external agencies to maintain timely and compliant credentialing processes. Responsible for tracking and scheduling clinic staff BLS/CPR renewal appointments.
Job Responsibility:
Compile and maintain current and accurate data for all providers
Track and schedule clinic staff BLS/CPR renewal appointments
Complete provider credentialing and recredentialing applications
monitor applications and follow-up as needed
Maintain copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
Maintain knowledge of current health plan and agency requirements for credentialing providers
Set up and maintain provider information in online credentialing databases and system
Track license and certification expirations for all providers to ensure timely renewals
Ensure clinic addresses are current with health plans, agencies and other entities
Process applications for appointment and reappointment of privileges to other healthcare facilities as applicable
Track license, DEA, and professional liability expirations for providers
Maintain appointment files, and information in credentialing database
Audit health plan directories for current and accurate provider information
Provides credentialing and privileging verifications
Consistently demonstrate good use of time and resources
Attend training events and maintain competency as required to perform duties
Regularly support compliance and accreditation efforts as assigned (e.g., OSHA, HIPAA)
Be familiar with and consistently implement the organizations mission and all approved policies, protocols, and procedures
Performs other duties that may be assigned from time to time
Requirements:
Intermediate knowledge of Microsoft Word, Outlook, and Excel applications
Ability to work independently with minimal supervision
Ability to organize and prioritize work and manage multiple priorities
Strong analytical and problem-solving skills
Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization
Effective verbal and written communication skills
Ability to maintain good judgement when handling sensitive and personal information