Credentialing Coordinator Job at Borrego Health

Borrego Health Escondido, CA 92025

Borrego Health provides high quality, comprehensive, compassionate primary health care to the people in our communities, regardless of their ability to pay. We serve these communities and adjoining regions with respect, dignity and cultural sensitivity as a medical home and safety net for essential health care and social services. Borrego Health is a non-profit 501(c)(3) Federally Qualified Health Center (FQHC) and a Federal Tort Claims Act Deemed (FTCA) facility.

Borrego Health is now the second largest health center in the country and the largest health center in the State of California! Join our team and make a difference today!

Summary:

Administers credentialing process, works independently to coordinate, develop, monitor and maintain the credentialing process under the supervision of the Medical Staff Office.

Essential Duties and Responsibilities:

1. Provides credentialing application packet to providers joining Borrego Health.
2. Provides recredentialing application packet to providers when applicable.
3. Tracks the providers’ application to ensure a timely submission for credentialing/credentialing.
4. Responsible for all primary source verification.
5. Analyzes and resolves provider file issues.
6. Responds to Provider inquiries received by letter, phone, email, faxes and other internal departments.
7. Processes credentialing applications in accordance with accreditation standards, regulatory requirements, and policies and procedures.
8. Organizes the monthly Credentialing Committee.
9. Maintains provider files to ensure current licenses, insurances, privileges, and all other required certifications and develops rosters to track dates of expirations.
10. Responsible for the organization, maintenance, and accuracy of medical staff data on hard copy files and electronic employee credentialing files (scanning all documents into Share/ Provider Management folder).
11. Works closely with the Director of Managed Care Operations to ensure provider information and files are up to date for managed care contracts.
12. Provide weekly/monthly reports as needed.
13. Performs other assigned duties.

Additional Information

You may also mail or fax your application and resume to the following address and telephone number:

Borrego Health
PO Box 2369
Borrego Springs, CA 92004
Fax: 858-634-6903
Borrego Community Health Foundation is an Equal Opportunity Employer. We encourage applications from all individuals regardless of race, religion, color, sex, pregnancy, national origin, sexual orientation, gender identity, gender expression, ancestry, age, marital status, physical or mental disability or any other protected class, political affiliation or belief.



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