Credentialing Specialist - Remote - 133045
Job Description
UCSD Layoff from Career Appointment: Apply by 11/4/2024 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 11/6/2024. Eligible Special Selection clients should contact their Disability Counselor for assistance.
We are seeking to hire a Credentials Specialist to be part of our internal Credentials Verification Operations (CVO) team and shall be accountable for performing the primary source verification process for all initial and reappointment applications. The Credentials Specialist will be responsible for sending, receiving, and processing, all credentialing applications for practitioners seeking medical staff and/or advanced practice professional membership and/or clinical privileges with UC San Diego Health, affiliation with UCSDH Physician Group, Clinically Integrated Network, or Population Health Services Organization and Managed Care Network. The Credentials Specialist will be responsible for performing primary source verification of education, training, experience, licensure, claims history, according to TJC, NCQA, CMS, AAAHC, state and federal accrediting standards. The Credentials Specialist will assure timely submission of applications and primary source verifications within specified time periods. Other duties as assigned.
MINIMUM QUALIFICATIONSMinimum seven (7) years of relevant experience, OR a Bachelor's Degree in relevant area and three (3) years of relevant credentialing experience; or equivalent combination of education and experience.
Experience and proven success in federal and state compliance guidelines in a medical setting.
Ability to perform all commonly applicable functions in Microsoft Office Suite (Word, Excel, PowerPoint) and medical credentialing database application.
Communication and interpersonal skills to interact with faculty and staff at all levels in a fast-paced environment under consistent pressure with the ability to work well with others and accept direction.
Certified Provider Credentialing Specialist (CPCS) OR preparing to obtain CPCS certification.
Knowledge of MSOW credentialing software and associated applications.
Must have access to high-speed internet when working remotely.
Must maintain certification status if CPCS certified.
Must be able to work various hours and locations based on business needs.
Employment is subject to a criminal background check and pre-employment physical.
Pay Transparency Act
Annual Full Pay Range: $63,800 - $111,600 (will be prorated if the appointment percentage is less than 100%)
Hourly Equivalent: $30.56 - $53.45
Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).
UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html
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