Job Description

The Credentialing Specialist will assist the Manager, Quality Management / Credentialing in all credentialing activities. The primary focus of the position is to process medical staff applications for physicians and allied health professionals in a confidential manner and that these documents are in compliance with NCQA Standards and health plan policies and procedures.

Duties and Responsibilities:Maintains medical staff bylaws, NCQA Standards and health plan policies and procedures that pertain to credentialing.Processes medical staff applications from receipt to completion.Performs the functions of primary source verification.Inputs data to MD Staff as assigned.Provides assistance in the preparation of credentialing and re-credentialing reports for the Credentials Committee.Supports the preparation of ICE reports, annual health plan and other audits as they pertain to credentialing. 
QualificationsEducation:

High school diploma or GED required. Associates degree preferred.

License/Certification:

Certified Provider Credentials Specialist (CPCS) preferred.

Experience:Two (2) years of prior credentialing experience in an ambulatory care/Medical Group or HMO setting with Managed Care exposure or in a TJC accredited hospital preferred.Knowledge of processing medical staff applications and accompanying documents preferred.
About UsCedars-Sinai is a leader in providing high-quality healthcare encompassing primary care, specialized medicine and research. Since 1902, Cedars-Sinai has evolved to meet the needs of one of the most diverse regions in the nation, setting standards in quality and innovative patient care, research, teaching and community service. Today, Cedars- Sinai is known for its national leadership in transforming healthcare for the benefit of patients. Cedars-Sinai impacts the future of healthcare by developing new approaches to treatment and educating tomorrow's health professionals. Additionally, Cedars-Sinai demonstrates a commitment to the community through programs that improve the health of its most vulnerable residents.
About the TeamWith a growing number of primary urgent and specialty care locations across Southern California, Cedars-Sinai’s medical network serves people near where they live. Delivering coordinated, compassionate healthcare you can join our network of clinicians and physicians to improve the healthcare people throughout Los Angeles and beyond.
Req ID : 4432
Working Title : Credentialing Specialist (Hybrid) - Quality Management
Department : MNS Quality Mgmt
Business Entity : Cedars-Sinai Medical Center
Job Category : Compliance / Quality
Job Specialty : Credentialing & Licensure
Overtime Status : NONEXEMPT
Primary Shift : Day
Shift Duration : 8 hour
Base Pay : $28.52 - $44.21