Credentialing Specialist - AD020

Native American Rehabilitation Assoc. of the NW•Portland, OR

1d•$26 - $32•Hybrid

About The Position

The Credentialing Specialist ensures that all medical, mental health, and alcohol & drug providers at NARA NW are properly credentialed, re-credentialed, and privileged in compliance with regulatory and health plan requirements. This role is essential in supporting quality patient care by ensuring providers are fully authorized to deliver services. With a focus on organization and attention to detail, the Credentialing Specialist plays a vital role in the healthcare team, contributing to a mission-driven organization dedicated to community well-being. This position offers the satisfaction of knowing your work directly impacts access to care while being part of a collaborative and supportive environment.

Requirements

High school diploma or equivalent required.
Two years of relevant credentialing experience required.
Must have a working knowledge of credentialing, medical terminology and regulatory agency requirements.
Experience with CMS Medicare enrollment, Medicaid, CAQH, FQHC accreditation and certification requirements.
Experience with medical credentialing and privileging procedures and standards.
Proficient use of Microsoft Office (Word, Excel, Outlook), Adobe Acrobat, and internet resources.
Professional interpersonal verbal and written communication skills
Demonstrates a high degree of accuracy, organization, flexibility, and ability to multi-task while prioritizing in a collaborative environment.
Must pass a pre-employment or for cause drug tests.
Must pass criminal background and DMV checks.

Nice To Haves

Experience working with Native American/ Alaska Native community is considered a plus.

Responsibilities

Works collaboratively, and maintains professional boundaries with clients, other NARA staff, team members, and always treat everyone with respect and dignity.
Compiles and maintains current and accurate data for all providers.
Conducts thorough background investigation, research and primary source verification of all components for the credentialing file.
Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
Prepares credentials file for presentation and approval.
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
Maintains knowledge of current health plans and agency requirements for credentialing providers.
Monitors provider status to ensure that providers are reappointed every 2 years.
Submits NPDB queries and monitors continuous queries.
Sets up and maintains provider information in credentialing software (Q-Genda).
Ensures practice information is current with health plans, agencies and other entities.
Responds to inquiries from other healthcare organizations, interfaces with internal and external customers on day-to-day credentialing and privileging issues as they arise.
Maintains confidentiality of provider information.
Provides credentialing and privileging verifications.
Complete yearly ongoing training & Medicare training as assigned

Benefits

14 Paid Holidays: New Years Day, Martin Luther King Jr. Day, Presidents Day, Memorial Day, Juneteenth, Battle of Little Big Horn, Independence Day, Labor Day, Native American Day, Indigenous Peoples’ Day, Veterans Day, Thanksgiving, day after Thanksgiving, and December 25th!
Affordable Medical, Dental, and Vision Insurance through Kaiser Permanente
13 Paid Days of Sick Time
13 Paid Days of PTO (Vacation accruals increase with years of service to a maximum of 26 days)
$50,000 Life Insurance & AD&D
Short Term and Long-Term Disability
Flexible Spending Account
Health Spending Account
401(k) with 4% Match
Employee Assistance Program
Inclement Weather Days (Snow Days)
Public Student Loan Forgiveness