Credentialing Specialist, Hybrid In-Office San Marcos, CA
About The Position
TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status. With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care. The Credentialing Specialist supports the Medical Staff department in ensuring that all healthcare providers are properly credentialed, privileged, and enrolled, and in compliance with federal, state, and organizational credentialing policies.
Requirements
- High School Diploma or equivalent.
- 3 to 4 years in a clinical- healthcare setting with relevant credentialing experience.
- Strong organizational skills and attention to detail.
- Computer proficiency with web-based applications and the Microsoft Office suite, including Outlook, Word, Excel and PowerPoint.
Nice To Haves
- Associate degree in Business or Healthcare Administration.
- MD Staff Credentialing Software knowledge.
- National Association Medical Staff Services Certification (NAMSS).
- Certified Provider Credentialing Specialist (CPCS).
- Certified Professional Medical Staff Management (CPMSM).
- Experience in healthcare or working in a Federally Qualified Health Center.
Responsibilities
- Collect and review initial credentialing and recredentialing applications.
- Ensure completeness and accuracy of documentation (licenses, certifications, malpractice insurance, etc.)
- Enter and update credentialed staff information in credentialing databases or software (e.g., MD-Staff, CAQH, NPPES)
- Verify provider credentials including education training, licensure, board certification, employment history and references.
- Contact licensing boards, educational institutions, and previous employers for primary source verification.
- Communicate with Licensed Independent Providers (LIPs), staff to obtain missing or expired documents.
- Track expiration dates and ensure timely renewal of licenses, DEA registrations, and other required documents.
- Audit credentialing databases to ensure accuracy and integrity of data.
- Generate and distribute credentialing reports and assist in preparing files for credentialing committee meetings.
- Process Continuing Medical Education (CME) requests.
- Process licensing reimbursement requests.
Benefits
- Competitive Compensation
- Competitive Time Off
- Low-cost health, dental, vision & life insurance
- Tuition Reimbursement
- Employee Assistance program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
