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Network Medical Management Inc: Credentialing Specialist

Company: Network Medical Management Inc
Location: Rosemead
Posted on: November 18, 2021

Job Description:

SUMMARYTo assist the Credentialing Verification Organization (CVO) in the processing of initial and reappointment credentialing applications for contracted cliental.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.Process initial and reappointment credentialing applications and conduct follow up as neededPrepare monthly reports for peer review/credentialing committee meetingsInput all credentialing data into credentialing software database accurately and timelyWork closely with IPAs and Hospitals to ensure exceptional customer serviceSubmit new network providers to contracted health plans with required profilesMaintain provider state licenses, DEA certificates, malpractice insurance and any other required credentialing documentsRepresents the CVO while interacting with internal and external contactsRemain up to date with credentialing accreditation standards with NCQA and Joint CommissionQUALIFICATIONSTo perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Ability to analyze complex application problems and provide solutionsAbility to work with multiple projects and deadlinesBasic knowledge of current accreditation standards of Joint Commission and NCQAExcellent written and verbal communication skillsDetail oriented and possess strong organizational skills in a fast-pace environmentEDUCATION and/or EXPERIENCEHigh School Diploma required, BA/BS Degree preferred2-3 years' experience with managed care, hospital or CVO credentialing requiredCPCS certification preferred HPIND

Keywords: Network Medical Management Inc, Rosemead , Network Medical Management Inc: Credentialing Specialist, Executive , Rosemead, California

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