Credentialing Specialist

Bestica Inc.; San Antonio (TX); On-site; USD 50,000 - 70,000; Full time

Job summary

Bestica Inc. is seeking a Credentialing Specialist in San Antonio, Texas, with significant experience in medical credentialing and proficiency in JCCQAS. The role includes completing PSV documentation, reviewing credentialing applications, and obtaining verifications from various sources. Ideal candidates will have at least three years of credentialing experience, including one year with the DoD. Strong organizational skills and attention to detail are essential for managing credentials efficiently.

Qualifications

• Three years of experience in medical credentialing.
• One year of credentialing experience with the DoD utilizing JCCQAS.

Responsibilities

• Complete written PSV documentation capturing the required components.
• Review credentialing applications and conduct follow-up for missing information.
• Contact various sources to obtain and complete the verification of credentials.
• Obtain required credentials and complete PSV from the originating source.
• Update JCCQAS screens and manage electronic credential files.

Skills

Experience in medical credentialing

Knowledge of credentialing and privileging process

Proficient with JCCQAS

Work history verifications

Data source knowledge

Tools

JCCQAS

Job description

• Three (3) years of experience in medical credentialing to include knowledge of the credentialing and privileging process, the required credentials for healthcare professionals, knowledge of appropriate sources used to complete PSV, work history verifications, and databank queries.
• One (1) year of credentialing experience with the DoD utilizing JCCQAS.

Responsibilities to include but not limited to:

• Completes written PSV documentation capturing the required components to document the PSV IAW DHA PM 6025.13, vol 4 and DAFI 44-119.
• Reviews credentialing applications, conduct follow-up to obtain missing credentials/information, conduct verifications, create provider credentialing records within JCCQAS and maintain the JCCQAS record.
• Contacts medical office staff, educational institutions, employers, licensing and certifying agencies, to obtain and complete the verification of credentials.
• Obtains required credentials and complete PSV of the credentials from the originating source or designated agent, date stamps the documentation upon receipt.
• Updates the appropriate screens within JCCQAS to capture the credential and PSV of the credential. Converts documentation to a PDF format, scans, appropriately names and uploads the documentation to the provider’s electronic credentials file.