Job Description

Join to apply for the Credentialing Specialist role at DAP Health At DAP Health, we are committed to transforming lives and advancing health equity for all. As a leading nonprofit health care provider, we deliver compassionate, high-quality care to the diverse communities of the Coachella Valley and San Diego County. Our comprehensive services range from primary care to mental health, wellness programs, and beyond, with a focus on those who are most vulnerable. Joining our team means becoming part of a passionate, innovative organization dedicated to making a meaningful impact in the lives of those we serve. If you’re looking for a dynamic and purpose-driven environment, we invite you to explore the opportunity to contribute to our mission. Job Summary The Credentialing Specialist plays a critical role in maintaining the integrity and regulatory compliance of our healthcare workforce. This position is responsible for managing credentialing operations for all licensed clinical staff, ensuring adherence to internal policies, regulatory standards, and Federal Tort Claims Act (FTCA) requirements. Key responsibilities include verifying and maintaining accurate, up-to-date credentialing documentation for all clinicians. The Credentialing Specialist also ensures that practitioners are properly credentialed and privileged in alignment with FTCA deeming guidelines, HRSA expectations, and applicable federal and state regulations. Essential Duties/Responsibilities Credentialing Operations Conduct and oversee initial and re-credentialing activities for all licensed personnel Review credentialing applications and supporting documentation for accuracy and completeness Serve as the primary point of contact for internal and external inquiries regarding credentialing status, providing timely updates and requested information Maintain and update the credentialing database to ensure all records are accurate and current Monitor and report upcoming expirations of licenses, board certifications, and other time-sensitive credentials Apply standardized credentialing and privileging procedures consistently across all licensed staff Identify and elevate credentialing concerns or red flags to appropriate managers and directors Assist in processing and distributing incoming correspondence related to credentialing activities Primary Source Verification Demonstrate working knowledge of state, federal, and accreditation standards related to credentialing and privileging Compile and review data on sanctions, complaints, and adverse actions associated with applicants Investigate discrepancies or adverse findings independently and validate information from applications and verification sources Communicate findings and recommended actions to relevant stakeholders Credentialing Committee Support Prepare documentation and materials for credentialing and privileging committee review Facilitate committee meetings and present applicant information Collaborate with internal departments to ensure credentialing activities align with organizational compliance requirements Qualifications Required Skills/Abilities Knowledge of healthcare regulations, including those related to Medicare, Medicaid, and commercial insurance plans Strong organizational and communication skills Attention to detail and ability to manage multiple tasks simultaneously Proficient in Microsoft Office Suite Education and Experience 3-5 years of experience in clinical primary source verification Credential for Provider Credentialing Specialist (CPCS) certificate desired but not required Experience working with credential software such as MD Staff, a plus Working Conditions/Physical Requirements This position is fully remote and is based out of the Southern California area This job operates in a home office setting and requires frequent sitting, standing, repetitive motion, and talking Ability to lift up to 50 pounds and move from place to place Ensures compliance with policies and procedures related to safe work practices #J-18808-Ljbffr DAP Health

Job Tags

Similar Jobs