Medical Credentialing Specialist and Administrator

Impact Lives, Impact Community

Family Health Centers of San Diego (FHCSD) is passionate about providing exceptional health care to all, especially underserved communities with limited health care options. Founded by a Latina grandmother/community advocate over 50 years ago in Barrio Logan, FHCSD has grown into one of the largest community health systems in the country. With over 90 sites, over 227,000 patients, and over 1.1 million healthcare visits last year, we provide a wide variety of health care and outreach services to a very diverse patient population. We are proud of our mission, our lasting community impact, and the cultural and individual diversity of our staff.

FHCSD is currently seeking a Medical Credentialing Specialist and Administrator. This position is responsible for processing and maintaining all necessary Provider and Medical Staff credentialing, privileging, and health plan enrollments. The position is housed in our main administrative office located in the University Heights area.

Duties and Responsibilities

• Coordinates credentialing and privileging for all Licensed Independent Practitioners per FHCSD policies, Joint Commission, NCQA and health plan requirements.
• Maintains and utilizes MD Staff software to track/maintain LIP credentialing and privileging information.
• Maintains signed mid-level agreements with applicable providers.
• Prepares agendas, minutes and communications for Clinical Review Committee.
• Processes and follows-up on individual and group applications for affiliated hospitals, health plans and government programs.
• Processes renewal applications of DEAs & Licenses for providers as requested.
• Provides reports and copies of credentials, forms, letters etc., as requested for audits and credentialing to FHCSD management, affiliated hospitals, health plans and government programs.
• Tracks and processes provider CME allowance request, including check requests for payment or reimbursement.
• Ability to work independently; possess problem solving and demonstrates creative thinking skills.
• Maintain good working relationships with employees, coworkers, and departments.
• Performs other duties as assigned.

Requirements

• 3 years of comprehensive credentialing experience preferred.
• 3-5 years experience in an administrative support role required.
• Experience in Human Resources department preferred.
• Knowledge of provider and independent practitioner credentialing and privileging.
• Certified Medical Staff Coordinator or Certified Provider Credentialing Specialist preferred.
• High school diploma or GED equivalent required. College coursework is preferred. Or equivalent combination of education and experience that provides the skills, knowledge and ability to perform the essential job duties, and which meets any required state or federal certification requirements.
• Ability to touch type 55 wpm and have excellent grammar, spelling and punctuation skills.
• Exceptional organizational skills, attention to detail, time-management skills, and strong motivation to meet deadlines and achieve goals.
• Intermediate skills in computer applications and software, including MS Office.
• Knowledge of medical terminology preferred.
• Traveling between sites and other locations is occasionally required. Must have a valid California driver's license, an automobile, and proof of minimum levels of car insurance as required under California law, although limits of $100,000 are recommended. An acceptable driving record is also required. California law requires all drivers to obtain a valid California driver's license within ten days of establishing residency. Reasonable accommodation may be provided on a case-by-case basis. Mileage and other reimbursement governed by policy.
• Bilingual (English/Spanish) preferred.

Pay and Benefits:

• $22.04 to $33.12 hourly
• Retirement Plan with 50% Employer Match
• Paid Time Off, Extended Sick Leave, Paid Holidays and Annual Raises
• Medical/Dental/Vision/FSA/Life Insurance
• Employee Discounts, Wellness Programs, Pet Insurance, and more

#IndAdmin

In the spirit of pay transparency, we are excited to share the base range for this position, exclusive of fringe benefits.

If you are hired at Family Health Centers of San Diego, your final base salary compensation will be determined based on factors such as geographic location, jurisdictional requirements, skills, education, and/or experience. In addition to these factors - we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please keep in mind that the range mentioned above is what we reasonably expect to pay for the role. Hiring at the maximum of the range would not be typical in order to allow for future and continued salary growth. We also offer a generous compensation and benefits package (more information on our benefits offerings is available here: FHCSD Wellness - Employee Hub (gobenefits.net)