Hybrid Credentialing Coordinator - Entry Level (Healthcare)

Cypress-Healthcare-Partners; Monterey (CA); Hybrid; USD 25,000 - 32,000; Full time

Job summary

Cypress Healthcare Partners located in Monterey is hiring a Credentialing Specialist. This entry-level role offers on-the-job training and a possible hybrid schedule after a 90-day introductory period.

You will ensure licensed practitioners are credentialed using our systems, supporting compliance and timely credentialing for the group. Responsibilities include gathering background information from physicians, communicating the process, maintaining credentialing documents, tracking license

Qualifications

• Excellent communication in English, written and spoken.
• Must maintain confidentiality and work well under productivity standards.
• Able to prioritize and balance the workload on short and long-term company needs.
• Must be able to work independently and solve problems efficiently and accurately.
• Able to create channels of communication to obtain information necessary to perform task.
• Strong organizational skills with the ability to prioritize a high-volume workload.
• Must be comfortable with MS Word, Excel, PowerPoint, and Outlook.

Responsibilities

• Collects background information from physicians to begin credentialing.
• Communicates with physicians the steps of the credentialing process.
• Prepares mailers and appropriate forms to payers and/or patients.
• Maintains copies of current state licenses, certificates, malpractice coverage, and other required credentialing documents.
• Tracks expiration dates on licenses to send renew reminders to physicians.
• Audits and evaluates processes involved in verifications for physicians’ and allied health professionals’ appointment, reappointment and privilege delineation.
• Ensures that all practitioners are initially cleared through required databanks (e.g., OIG, SAMS, NPDB) and then establishes and follows policies and procedures for subsequent periodic database searches, using the features of eVIPs credentialing software whenever possible.
• Coordinates the processing of practitioner applications. Assures all applications are processed completely and in a timely manner.
• Generates reports to include insurance approval dates.
• Serves as information resource in credentialing to physicians and allied health professionals.
• Maintains copies of current state licenses, certificates, malpractice coverage, and other required credentialing documents, including physician files.
• Ensures the critical timing factors, such as active CA medical license, DEA license and malpractice insurance coverage.
• Important expiration dates are properly calendared in the eVIPs system, allowing for adequate time to ensure timely renewals.
• Continuously looking for ways to streamline and automate the physician and allied health professional credentialing and payer contracting processes.
• Implements and optimizes use of eVIPs “eStatus” features that will allow select users to access limited information in eVIPs about the status of a Group’s or Practitioner’s credentialing with a payer.

Skills

English fluency

Confidentiality

Prioritization

Independent worker

Communication

Organization

MS Office

Team player

Education

High School Diploma or Equivalent

Tools

Microsoft Word

Microsoft Excel

PowerPoint

Outlook

Job description

Cypress Healthcare Partners located in Monterey is hiring a Credentialing Specialist. This entry-level role offers on-the-job training and a possible hybrid schedule after a 90-day introductory period.

You will ensure licensed practitioners are credentialed using our systems, supporting compliance and timely credentialing for the group. Responsibilities include gathering background information from physicians, communicating the process, maintaining credentialing documents, tracking license