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Remote Credentialing Specialist

San Antonio, CA · Healthcare
Department of Defense – Guard Bureau, Credentialing and Privileging  

 
Role: Credentialing Specialist 
Type: Full-Time  
Travel Required: Occasional travel at government request is possible  

 
ROLE AND RESPONSIBILITIES  
Credentialing Specialist have overall knowledge of the credentialing and privileging process and apply their advanced skills and experience in performing end to end credentialing functions. They may provide Quality Review and Quality Control to work produced by credentialing assistant staff processing credentialing transactions. They demonstrate a thorough knowledge on credentialing policies, guidelines, and regulations for the DoD credentialing process.  
A Credentialing Specialist is qualified to perform tasks such as:  
  • Completes and processes healthcare-provider credentialing and recredentialing applications and privileging requests 
  • Ensures providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities 
  • Enforces regulatory compliance and quality assurance at a healthcare facility, insurance group, or similar organization, ensuring that physicians and healthcare facilities or organizations follow relevant regulations 
  • Keeps records and documentation of the applications and verifications maintained 
  • Monitors applications, and follows-up as needed to get closure\completion 
  • Responds to providers requests for information   
QUALIFICATIONS AND EDUCATION REQUIREMENTS   
  • Two plus (2+) years in medical credentialing   
  • Strong interpersonal skills  
  • Strong oral and written communication skills  
  • Exceptional attention to detail  
  • Exceptional analytical skills  
  • Customer interaction experience 
PREFERRED SKILLS   
  • One plus (1+) year of experience in DoD credentialing using CCQAS or JCCQAS   

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