Credentialing & Provider Enrollment Specialist
Company: Sea Mar Community Health Centers
Location: Federal Way
Posted on: February 20, 2021
Sea Mar Community Health Centers, a Federally Qualified Health
Center (FQHC) founded in 1978, is a community-based organization
committed to providing quality, comprehensive health, human,
housing, educational and cultural services to diverse communities,
specializing in service to Latinos in Washington State. Sea Mar
proudly serves all persons without regard to race, ethnicity,
immigration status, gender, or sexual orientation, and regardless
of ability to pay for services. Sea Mar's network of services
includes more than 90 medical, dental, and behavioral health
clinics and a wide variety of nutritional, social, and educational
services. We are recruiting for the following position:
Credentialing & Provider Enrollment Specialist - Posting #20862
Sea Mar Community Health Centers seeks an experienced Credentialing
& Provider Enrollment Specialist. This is a Full-time position
(Monday-Friday) 8:00 am to 5:00 pm. The Credentialing Specialist be
responsible for coordinating all aspects of the privileging and
credentialing process for the licensed independent practitioners
(LIPs) in accordance with the Policies & Procedures, national
standards and regulatory requirements.
Duties and Responsibilities:
- Maintain regular cooperation and compliance with all
regulatory, accrediting, and membership-based organizations.
- Create and carry out various credentialing processes in
relation to licensed providers in medical, dental and behavioral
- Ensure that all credentialed providers adhere to facility and
staff policies, department guidelines, regulations, and government
- Process applications and reappointment paperwork, checking for
full completeness and accuracy.
- Perform provider credentialing/qualifying process to ensure all
requirements are met in accordance with credentialing requirements
prior to presentation to Board of Directors.
- Ensure that all credential files are current and complete
pursuant to expiration date of medical licenses, board
certification, professional-liability insurance coverage, DEA and
other pertinent information, per HPP and/or client facility policy
- Coordinate credentialing process by entering/logging/scanning
information into MD Staff credentialing software for initial,
updating, and add on applications and maintenance processes.
- Collect and verify sensitive provider data through confidential
- Maintain timely updates to information systems and regular
reports used to monitor completion of initial and reappointment
- Audit files based on internal standards and regulatory
- Monitor and report application status and provide appropriate
correspondence (form letters) to providers and department heads
- Provide complete and accurate credentialing files to
Administration for inclusion in Board of Directors' materials.
- Working knowledge of Joint Commission, NCQA and CMS
credentialing and privileging standards and experience with
provider and health plan credentialing.
- Intermediate computer skills including Microsoft products and
web based queries.
- Demonstrated ability to manage and meet multiple priorities and
competing deadlines, problem solving and organization skills with
attention to details. Experience with credentialing software is
desirable, MD Staff preferred.
Education and/or Training:
- Current NAMSS Certified Provider Credentialing Specialist
(CPCS) or actively pursuing certification and certification
obtained within 2 years of hire date.
- Previous work experience in managed care, hospital or medical
office environment required.
- Experience with delegated health plan credentialing agreements
What We Offer:
Sea Mar offers talented and motivated people the opportunity to
work in a dynamic and growing community health organization.
Working at Sea Mar Community Health Centers is more than just a
job, it's a fulfilling career with opportunity for advancement. The
fringe benefits surpass most companies. For example, employees
Full-time employees working 30 hours or more, receive an excellent
benefit package of Medical, Dental, Vision, Life Insurance,
Prescription coverage, Long Term Disability, EAP (Employee
Assistance Program), paid-time-off starting at 24 days per year +
10 paid Holidays. We offer 401(k)/Retirement options and an
exciting opportunity to work in a culturally diverse
How to Apply:
To apply for this position, complete the online application and
click SUBMIT or APPLY NOW. If you have any questions regarding the
position, email Letriana Santiago, Credentialing and Provider
Enrollment Supervisor at
Sea Mar is an Equal Opportunity Employer
Please visit our website to learn more about Sea Mar at . Follow us
on Facebook, Twitter, and Instagram
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Keywords: Sea Mar Community Health Centers, Federal Way , Credentialing & Provider Enrollment Specialist, Other , Federal Way, Washington
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