Credentialing Analyst 8/12/2016
San Francisco, CA
JOB DESCRIPTIONAPPLY REQUIRED QUALIFICATIONS
* Bachelor's degree or equivalent combination of education and experience
* A minimum of seven years in healthcare environment with emphasis in medical staff operations, academic medical centers and/or provider credentialing for third party payors and health plans,
* Expert knowledge of TJC, NCQA, CMS, DHS, DMHC, ACGME and other applicable accreditation/regulatory requirements
* Advanced competency in a paperless computer environment and understanding of provider data integrity standards (credentialing software, MS Office suite, Adobe Professional, document scanning/storage, web based applications and tools, etc.)
* Excellent ability to: interact with all levels of management; communicate effectively, both verbally and in writing; and, function within a team and independently.
* Exceptional organizational skills and ability to set priorities as well as manage multiple demands effectively.
* Role models and promotes best practices to maintain confidentiality and discretion to preserve
* HIPAA/Peer review protections as well as attorney-client privilege, as warranted.
* Knowledge of compliant revenue/billing practices to mitigate fraud/waste/abuse impacts on organization priorities/workplans.
* This position requires flexibility to orient and work at all the company's Medical Center locations.
* Identify all licenses or certifications required by law or the company's Medical Center policies to perform the duties, i.e., a California Registered NurseLicense (RN), California Nurse Practitioner License (NP), or a California driver's license (CDL).
* CPMSM, CPCS, CPHQ, or CPC (within 18 months of starting the position)