San Francisco, CA, 94103, USA
22 hours ago
Credentialing Specialist
**Duration:** 05 Months contract with possible extension upto 18 months **Key Responsibilities:** + Oversee ED Call Schedule and manage committee meetings, including minutes, agendas, and scheduling. + Screen and pre-vet applicants, ensuring all credentialing data is accurate and complete. + Enter and maintain provider data in credentialing systems (Cactus, ECHO). + Audit completed credentialing applications and route files for departmental approval. + Prepare credentialing files for committee review/approval and ensure compliance with bylaws and accreditation standards (TJC, NCQA, CMS, state/federal regulations). + Assist with OPPE/FPPE competency data and track expiring licenses/certifications. **Required Qualifications:** + Minimum 3 years of experience in credentialing, compliance, audit, or healthcare administration. + Bachelor’s degree in a related field or equivalent experience/training. + Proficiency in Cactus and ECHO credentialing systems, Microsoft Office Suite, and data management. + Strong analytical, multitasking, and problem-solving skills with the ability to work under deadlines. + Ability to collaborate across departments and effectively communicate with stakeholders. **Certification Requirement:** + Must obtain Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) within 18 months of hire. **Preferred Qualifications:** + Experience in a community hospital setting. + Expert knowledge of accreditation and regulatory requirements (TJC, NCQA, CMS, etc.). **Background/experience in the following duties and responsibilities include:** + ED Call Schedule, Committee meeting management including minutes, agenda and scheduling, screening applicants and pre-vetting, data entry into credentialing systems, experience with Cactus and ECHO systems, auditing completed credentialing applications, routing credentialing files for departmental approval, helps prepare files for committee review/approval, monitors file compliance under the bylaws, state/federal regulatory and accreditation agencies, assisting with OPPE/FPPE competency data, and monitoring expirable. **Job Function Summary:** + Involves the development, implementation and monitoring of effective and efficient systems to facilitate all aspects of medical staff services and credentialing. + Provides for the processing of applications and verification of physician licensing and certifications. + May also involve the preparation of agendas and related materials for medical staff meetings and peer review activities. + May serve as the liaison between the medical staff and all hospital departments to coordinate and provide overall continuity of medical staff activities. + Monitors compliance with medical staff bylaws, rules, regulations, policies and procedures.
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