Physician Credentialing Specialist

Community First Health Plans • San Antonio, TX

52d

About The Position

Responsible for provider oversight of the verification process of provider credentialing to ensure compliance with Community First Health Plans (CFHP) policies and procedures. Oversees the daily activities associated with the efficient operation of the provider credentialing process, in cooperation with the Network Management department, Quality Management department and the Medical Director.

Requirements

• High school diploma/GED required.
• Three years of healthcare environment office experience required.
• Exceptional organizational skills
• accuracy in administrative/secretarial duties
• medical terminology
• knowledge of spreadsheets and word processing software are required.

Nice To Haves

• Two years of credentialing experience preferred.
• Knowledge of NCQA standards, state licensing board and other state requirements and regulations with reference to provider credentialing preferred.

Responsibilities

• provider oversight of the verification process of provider credentialing
• ensure compliance with Community First Health Plans (CFHP) policies and procedures
• oversees the daily activities associated with the efficient operation of the provider credentialing process
• cooperation with the Network Management department
• cooperation with Quality Management department
• cooperation with the Medical Director

What This Job Offers

• Education Level: High school or GED
• Number of Employees: 251-500 employees