Credentialing Specialist

The job responsibilities of the Credentialing Department Administrative Specialist include:

1. Carrying out all administrative duties of the Credentialing Department.
2. Providing expansive organizational support and general administrative/clerical assistance.
3. Preparing and managing files for the Credentialing Committee.
4. Responding to telephone calls as a secondary responder, ensuring correct departmental redirection within the organization.
5. Organizing and maintaining the credentialing department's filing systems, including files, reminders, committee, and publication binders.
6. Managing daily incoming and outgoing mail as well as payroll check coordination and distribution within the division.
7. Coordinating extensive mailing projects.
8. Monthly updating of the Credentialing database, including credentials expired with Medical Board of California, Drug Enforcement Agency, specialty board certifications, and malpractice insurance.
9. Processing credentialing/recredentialing applications promptly and accurately in compliance with B& T procedures, health plan delegation, and NCQA standards.
10. Regular database input and update for Credentialing tasks.
11. Compiling files and materials necessary for external audits by payors or government agencies.
12. Broadcasting updated or new professional information to HMOs and various departments.
13. Purchasing supplies, maintaining subscriptions, handling expense reports, and performing check requests, faxing, and scanning tasks to support the division.

• At least two years of proven administrative experience in healthcare or related field.
• Exceptional writing skills, including spelling and grammar.
• Proficiency in Microsoft Office applications such as Word, Excel, Visio, and Access.
• Ability to work well in a team, demonstrating excellent organizational skills.
• Strong interpersonal skills.
• Ability to prioritize tasks effectively, multi-task and work independently with minimum supervision.
• Possession of a High School Diploma or its equivalent.