Credentialing & Contracting Department

  • 사무직
  • Anaheim
  • hans
  • 6/30/2020
Credentialing & Contracting Department

Responsible for data entering and document verification of healthcare provider information through in depth detailed research of information. Primary methods of researching information include internet, phone, fax and e-mail. Responsible for expanding/maintaining the provider network through contracting efforts.
• Contact providers to initiate initial credentialing or re-credentialing process
• Update expired documents such State licenses, DEA licenses, and malpractice insurances
• Manage and organize the credentialing folders and files
• Input provider data through user friendly database
• Create monthly credentialing meeting minutes
• Assist the department with regular health plan audits
• Perform other duties as assigned
• Obtain contracts and letters of agreement (LOAs) from providers who want to join our network
• Coordinate with other departments to obtain contracts/LOAs with requested providers
• Call/follow-up with providers on a regular basis to obtain contracts/LOAs
• Prepare contracts/LOAs for monthly credentialing board meeting
• High school graduate/diploma
• Comfortable being on the phone /proper phone etiquette
• Have strong computer and typing skills: includes MS Word, Excel, Adobe, and Internet
• Detail oriented with ability to recognize vital information when verifying  documents
• Possess proof-reading skills sufficient for auditing documents
• Ability to prioritize well and meet overlapping deadlines
• Demonstrate effective written/verbal communication skills
• Demonstrates problem-solving, critical thinking, and deductive reasoning skills
Preferred Qualifications
• At least 1 year of credentialing experience (Medicare Advantage/Managed Medicare)
• Familiar with the credentialing process; with what type of organization/company an MSO is; with health care/managed care
Monday to Friday (all days)
8:30 AM to 5:30 PM (whole duration, 1-hour lunch in between)
Job Type: Full-time
• Anaheim, CA (Required)
Work authorization:
• United States (Required)
Working Days:
• Monday (Required)
• Tuesday (Required)
• Wednesday (Required)
• Thursday (Required)
• Friday (Required)

Resume submission:

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