Credentialing Specialist

Full Time
San Diego, CA 92121
Posted
Job description

Scripps Health Administrative Services supports our five hospitals and 19 outpatient facilities, which treat half a million patients annually through 2,600 affiliated physicians.

At Scripps Health, you will experience the pride, support, respect that has been repeatedly recognized as one of the nation’s Top 100 Places to work.

You’ll be surrounded by people committed to making a difference in the lives of their patients and their teammates. So if you’re open to change, go ahead and unlock your potential.

The Credentialing Specialist is accountable for primary source verification and analysis of all applicant information and reappointment information in accordance with Accreditation and Licensure Standards, California State and Federal Laws, Medical Staff Bylaws and related policies. The position interfaces with applicants, medical staff officers, leadership and department staff. Responsible for maintaining confidentiality of all information.

You may travel to facilities, attend Credentialing/Board meetings, and work closely with Medical Staff Coordinators and Managers. Additionally, you must maintain knowledge of facility-specific Medical Staff Bylaws for entire system, and Rules and Regulations, as they relate to the credentialing process. Create necessary forms and reports related to processing appointment and reappointment applications.

This is a full time, benefit eligible position located on the Scripps Mercy Hospital campus in Hillcrest.



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Required Education/Experience/Specialized Skills:

  • High School Diploma/GED.
  • At least one year of credentialing experience in an integrated health care delivery system inclusive of hospital and health plan credentialing.
  • Knowledge of NCQA, Joint Commission, NPDB guidelines, applicable State and Federal regulations.

Required Certification/Registration:

  • CPCS or CMSC within 2 years of employment.

Preferred Education/Experience/Specialized Skills/Certification:

  • Bachelor's Degree in Related Field.
  • CPCS or CMSC.
  • 2-3 Years of post-high school administrative role requiring a high degree of analytic ability, coordination of processes in a fast paced environment.
  • Experience with the MD Staff credentialing software or similar.
  • Basic knowledge of medical terminology.

Scripps Health is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with disability.

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