Provider Credentialing Specialist

PATH (People Assisting The Homeless) (Old); Riverside (CA); On-site; USD 3,638,000 - 4,731,000; Full time

Job summary

PATH (People Assisting The Homeless) (Old) is seeking a Credentialing Specialist in Riverside, CA. This is a full-time, non-exempt position focused on establishing, monitoring, and maintaining provider credentialing with employer groups, managed care organizations, insurance companies, medical staff offices and physicians.

You will manage licenses, renewals, and regulatory compliance, maintain credentialing files, and communicate findings to Medical Directors and supervisors.

Qualifications

• Strong organizational skills and attention to detail.
• Proficient in Microsoft Office; able to work with databases and internet apps.
• Excellent verbal and written communication; teamwork with diverse groups.
• Keeps abreast of laws and regulatory requirements.
• Maintains high standards of professionalism and ethics.

Responsibilities

• Establishes, monitors and maintains provider credentialing with employer groups, managed care organizations, and licensing bodies.
• Maintains up-to-date licenses, certifications, and renewal dates for providers.
• Processes initial credentialing applications and manages ongoing privileges.
• Queries National Practitioner Data Bank and ensures timely credentialing actions.
• Communicates with Medical and Dental Directors and reports expirations monthly.

Skills

Organizational skills

Microsoft Office

Verbal and written communication

Interpersonal skills

Regulatory awareness

Education

High school diploma

Associate's degree or equivalent

Job description

PATH (People Assisting The Homeless) (Old) is seeking a Credentialing Specialist in Riverside, CA. This is a full-time, non-exempt position focused on establishing, monitoring, and maintaining provider credentialing with employer groups, managed care organizations, insurance companies, medical staff offices and physicians.

You will manage licenses, renewals, and regulatory compliance, maintain credentialing files, and communicate findings to Medical Directors and supervisors.