Credentialing Specialist

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.


Job Summary


Our client is seeking a Credentialing Specialist responsible for ensuring that credentialing standards are met for new healthcare providers. The specialist will work closely with dental health providers and staff to ensure accurate records, maintain data integrity, and complete credentialing and recredentialing processes.


Key Responsibilities

• Collaborate with dental health care providers to collect relevant data ensuring record accuracy.
• Ensure New Provider applications meet credentialing standards before approval.
• Maintain data accuracy through various resources and databases.
• Compile and analyze data to ensure records completeness and accuracy.
• Review and screen applications for compliance with federal, state, and local regulations.
• Conduct primary source verification to validate document accuracy.
• Identify and resolve discrepancies in credentialing processes.
• Monitor file completeness and prepare information for internal and external stakeholders.
• Enter and maintain provider data in credentialing databases.
• Participate in process improvements and reports preparation.

Qualifications

• Bachelor's degree, plus 5 years in credentialing or related fields, OR 9 years of relevant experience.
• Knowledge of dental provider credentialing and accreditation policies.
• Working knowledge of clinical and hospital operations.

Skills

• Ability to communicate effectively both orally and in writing.
• Strong customer service skills.
• Proficiency in Microsoft Word and Excel.
• Advanced skills in spreadsheet and database management.
• Ability to maintain confidentiality and use independent judgment.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


Medix Overview:


With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.


Any required state or Joint Commission training is compensated at the state or local minimum wage rate.


* As a job position within our Insurance division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing medical and confidential records, verifying financial information, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients