Credentialing Specialist

Credentialing Specialists ensure that medical staff members' of Cottage medical Group and Ambulatory network maintain current credentials with all insurance payers and licenses to work legally in their field or specialty.

These specialists monitor upcoming renewal dates and work with medical staff to advise them of the required steps to maintain their credentials with insurance payers.

They also review information on potential new employees to make sure all required licenses and credentials with insurance payers are current before hiring.

QUALIFICATIONS

All job qualifications listed indicate the minimum level necessary to perform this job proficiently.

LEVEL OF EDUCATION

Minimum:

Preferred: Associate's or Bachelor's Degree

CERTIFICATIONS, LICENSES, REGISTRATIONS

Minimum:

Preferred: Acheive a minimum of 30 credit awarded by NAMSS National Association Medical Staff Services in the first two years of employment.

TECHNICAL REQUIREMENTS

Minimum: Intermediate MS Word, Excel, Outlook, and PowerPoint skills.

Preferred: Knowledge off billing regulations and requirements for both Government and Nongovernment payers.

Knowledge of insurance plan policies and procedures for credentialing and enrollment.

YEARS OF RELATED WORK EXPERIENCE

Minimum: 1 years of credentialing experience working with government and commercial insurance payers.

Preferred: 5-7 years of credentialing experience working with government and commercial payers and developed relationships with insurance payers; Reporting specific deadlines and areas for improvement.

MD Staffing database proficiency.

Medical billing office experience
Cottage Health is a leading acute care hospital system, located on the central coast of California, widely known for our superior patient care, innovation, medical research and education.

Our health system operates primarily in Santa Barbara, Ca, since 1888, and consists of three acute care hospitals, a Rehabilitation Hospital, multiple clinics and a multi-site Urgent Care system.

Our mission is to serve the central coast communities with excellence, integrity, and compassion.

Every day we touch thousands of lives in many different ways, resolute in our mission to put patients first.

We take pride in helping our patients get back to living their lives - in the places they love.

Cottage Health is an Equal Opportunity Employer.

Cottage Health applicants are considered solely based on their qualifications, without regard to race, color, ethnicity, religion, age, gender, transgender, gender expression and identity, national origin, ancestry, disability, sexual orientation, marital status, military status or any other classification protected by law.

This policy applies to all aspects of the relationship between Cottage Health and an applicant or employee.

Cottage Health is committed to upholding discrimination-free hiring practices.

We strive to cultivate an environment where exceptional people bring diverse perspectives and find belonging, support ...