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JOB TITLE:Credentialing Specialist I


This REQ is for 1 Opening:Position Purpose: Perform credentialing and related activities based on plan specifications

Perform credentialing and re-credentialing activities according to plan specifications and in compliance with NCQA standards
Communicate with professionalism with physicians, office managers, providers, and other third parties to secure needed information
Gather information for Credentialing Committee meetings
Process, track and file credentialing applications within established standards
Generate and utilize reporting to support business functions
Ability to thrive in a fast-paced production environment while maintaining quality

Education/Experience: Associate s degree, or high school diploma/equivalent and 1+ years of data entry, customer service, medical office, provider data management, credentialing or healthcare operations (i.e. claims processing, billing, provider relations or contracting) experience, preferably in a managed care or insurance environment.

Map: San Rafael CA
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