Credentialing Specialist

Bestica Inc.; San Antonio (TX); On-site; USD 65,000 - 90,000; Full time

Job summary

Bestica Inc. seeks an experienced credentialing professional to manage PSV documentation and provider credentialing records. The role involves verifying credentials, contacting medical offices and licensing agencies, and maintaining accurate records in JCCQAS.

Responsibilities include processing DHA PM 6025.13, vol 4, and DAFI 44-119 compliant documentation, as well as converting and uploading files to the provider’s electronic credentials file.

Qualifications

• Three years of medical credentialing experience.
• Knowledge of PSV processes and required credentials for healthcare professionals.
• Experience with verifications and databank queries.
• Familiarity with DoD credentialing systems is a plus.

Responsibilities

• Completes PSV documentation per DHA PM 6025.13, vol 4 and DAFI 44-119.
• Reviews credentialing applications and follows up to obtain missing credentials.
• Creates provider credentialing records within JCCQAS and maintains records.
• Contacts medical offices, educational institutions and licensing agencies to verify credentials.
• Obtains credentials and completes PSV from originating sources, date stamping on receipt.
• Updates JCCQAS screens to capture credentialing details and PSV, converts docs to PDF, uploads to the provider’s file.

Skills

Medical credentialing

PSV documentation

DoD JCCQAS

Verifications

Records management

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.