Credentialing Lead — Compliance & Team Growth

Bass Privia Management Company of California, LLC; Walnut Creek (CA); On-site; USD 120,000 - 160,000; Full time

Job summary

Bass Privia Management Company of California, LLC seeks a Credentialing Team Lead to oversee the credentialing process for healthcare providers and ensure regulatory compliance. You will lead, support, and develop the credentialing team while maintaining accurate and timely credentialing activities.

Responsibilities include monitoring expirable credentials, maintaining staff databases, and ensuring coordination with other departments.

Qualifications

• Excellent written and verbal communication and customer service.
• Ability to stay organized and perform effectively in a fast-paced environment.
• Strong judgment and decision-making skills.
• Five+ years of experience managing various insurance types (HMO, FQHC, PPO, IPA).
• Medicare PECOS and Medi-Cal PAVE enrollment experience required.
• Experience with DME revalidations, reassignments, and enrollment.
• Strong complex problem-solving skills.
• Experience coaching, mentoring, and developing others.

Responsibilities

• Monitors expirable credentials and documents for all providers.
• Answers escalated departmental emails and incoming calls.
• Develops and maintains credentialing for new providers and reappointments.
• Monitors compliance with federal and state regulations among medical staff.
• Maintains a comprehensive database of medical staff information.
• Oversees privileging and credentialing documents for accuracy.
• Facilitates communication between medical staff and other departments.
• Consults with external organizations to ensure regulatory compliance.
• Supports quality improvement programs and initiatives.
• Performs other duties as assigned.

Skills

Communication skills

Customer service

Organization

Decision making

Insurance enrollment experience

Mentoring

Quality improvement

Education

Some college coursework preferred

Tools

CredentialStream

Cactus

CredentialMyDoc

Excel

Outlook

Zoom

Microsoft Teams

Word

Adobe PDF

Internet research

Job description

Bass Privia Management Company of California, LLC seeks a Credentialing Team Lead to oversee the credentialing process for healthcare providers and ensure regulatory compliance. You will lead, support, and develop the credentialing team while maintaining accurate and timely credentialing activities.

Responsibilities include monitoring expirable credentials, maintaining staff databases, and ensuring coordination with other departments.