Credentialing Coordinator- Bakersfield 1.1

Description

Location: Bakersfield, CA 93309 (Onsite)
 

Classification: 

Full-Time (Non-Exempt)

Benefits:

· Medical 

· Dental 

· Vision

· Simple IRA Plan

· Employer Paid Life Insurance

· Employee Assistance Program

Compensation:

The initial pay range for this position upon employment commencement is expected to be between $45,760.00 and $57,179.00 annually, translating to $22.00 to $27.49 per hour. However, the base pay offered may be adjusted based on individualized factors, including the candidate's education, certifications, skills, and experience. We value exceptional talent and strive to provide competitive compensation packages tailored to attract and retain top candidates like yourself.

Position Summary: 

This position supports credentialing activities for all product lines managed by UHC MSO. The

Credentialing Coordinator will assist the Lead Credentialing Specialist and work closely with the

leadership team, health plans, providers, and provider office staff to ensure all providers meet the

necessary credentialing standards. Responsibilities include identifying, obtaining, and verifying

credentials for licensed practitioners during both the initial credentialing and re-credentialing

processes under the guidance of leadership. The role also involves preparing credential files for

review by leadership and the Credentialing Committees, maintaining accurate electronic and

physical records, and ensuring credentials are up to date. Additionally, the Credentialing

Coordinator will help draft and track policies and procedures, create Desk Level Procedures

(DLPs) and manage related documents and forms.

Job Duties and Responsibilities:

• Keep current on all health plan credentialing standards, policies, and procedures.

• Maintain access to all Primary Source Verification websites.

• Assist with performing internal primary source verifications and full credentialing for

providers to be credentialed.

• Keep all credentialing files and credentialing database current and complete.

• Attend assigned meetings pertaining to provider credentialing and provider network

management.

• Coordinate credentialing activities with management as needed and keep management

informed of their status regularly.

• Validate information in master credentialing database against information in health plan

database.

• Ensuring regular and clear communication with the leadership team.

• Follow required office procedures in a cooperative manner.

• Other duties as assigned.

Requirements

Qualifications:

• High school diploma or equivalent.

• Credentialing experience and knowledge of NCQA standards preferred.

• Experience in managed care environment preferred.

• 2+ years of medical and/or dental office experience preferred.

• 2+ years of healthcare credentialing experience and CPCS preferred.

• Typing 40 WPM.

• Strong written communication skills, especially with grammar and spelling.

• Attention to detail and accuracy.

• Strong computer skills must be able to run reports and manipulate/track/log data.

• Advanced Word, Excel, Adobe Pro and Outlook skills required.