CPT-9958 Credentialing Specialist – California & Nevada

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Position Overview

20four7VA is actively seeking an offshore independent contractor to fill the role of Credentialing Specialist. This position is specifically available to candidates based in California and Nevada. As a Credentialing Specialist, the individual will play a crucial role in managing and maintaining the credentialing and re-credentialing process for healthcare providers. The position requires a strong understanding of various state, federal, and payer-specific requirements that are vital for ensuring compliance within the healthcare industry.

Responsibilities

The primary responsibilities associated with the Credentialing Specialist position at 20four7VA include:

• Managing the credentialing processes for healthcare providers, ensuring that all credentials are up-to-date and compliant with applicable standards.
• Coordinating the re-credentialing process, ensuring timely submission and follow-up of necessary documentation.
• Ensuring compliance with regulations from state and federal agencies, as well as payer-specific guidelines.
• Maintaining organized records and documentation related to the credentialing processes.
• Collaborating with other healthcare professionals and administrative staff to expedite the credentialing process.

Required Skills and Qualifications

To be considered for this position, applicants must meet certain qualifications and possess various skills:

• Minimum of 2 years of experience in credentialing or provider enrollment in a healthcare setting.
• Strong familiarity with California and Nevada payer requirements, including key programs such as Medi-Cal and Nevada Medicaid, along with major commercial plans.
• Experience with critical systems including Medicare (PECOS), NPPES, and CAQH is required.
• Knowledge of credentialing standards set by organizations such as NCQA, CMS, and the Joint Commission is highly preferred.

Salary and Benefits

Unfortunately, the detailed salary information for this role was not specified in the job posting. However, working as a Credentialing Specialist under a freelance contract often provides competitive pay rates, especially considering the estimated level of expertise and the complexities involved in healthcare credentialing.

Being a freelance role allows for flexible working hours and the potential for remote work, making it ideal for those who seek a balance between professional duties and personal commitments.

Application Process

Candidates interested in applying for the Credentialing Specialist position at 20four7VA can expect the application process to involve submitting a resume and possibly a cover letter. It’s essential for applicants to highlight relevant credentials, experience in healthcare settings, and familiarity with state requirements in their application materials.

Additionally, candidates may benefit from preparing for an interview by brushing up on their knowledge about credentialing standards and compliance measures. Given the nature of the job, showcasing strong organizational skills and the ability to work independently will be advantageous during the selection process.

Conclusion

In summary, the Credentialing Specialist position at 20four7VA offers an exciting opportunity for individuals with a background in healthcare credentialing to contribute to important compliance efforts. With a focus on flexibility and autonomy through a freelance contract, it positions itself as a compelling job opportunity, particularly for those based in California and Nevada. Job seekers who meet the outlined qualifications and possess the necessary skills are encouraged to apply and take the next step in their careers within the healthcare sector.

This job offer was originally published on himalayas.app