Credentialing Specialist

Zoek Pin San Antonio Prairie, TX

Competitive

Permanent (Full time)

Posted 17 days ago

Department:

Federal

Location:

San Antonio, TX

Decypher is seeking an experienced Credentialing Specialist in San Antonio, TX.

RESPONSIBILITIES

  • Performs credentialing tasks in support of the processes managed by the senior credentialing specialists and in response to MTFs requests
  • Designated AFMS agent to gather credentialing information, perform PSV of healthcare professionals’ credentials and conduct databank queries
  • Reviews credentialing applications, conduct follow-up to obtain missing credentials/information, conduct verifications, create provider credentialing records within CCQAS and maintain the CCQAS record
  • Contacts medical office staff, educational institutions, licensing and certifying agencies, to obtain and complete the verification of credentials
  • Obtains required credentials and complete PSV of the credentials from the originating source or designated agent, date stamps the documentation upon receipt
  • Identifies and reports potential “red flags” to the requestor and submits required credentials verification summaries
  • Transfers provider credentials files to MTF credentials office or training office as appropriate. Closes out and inactivates electronic CCQAS records when appropriate

QUALIFICATIONS

  • High School Degree or Equivalent
  • 3 years of Medical Credentialing
  • 1 year Credentialing with DoD JCCQAS / CCQAS
  • US Citizen
  • NACI Clearance
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