Credentialing Specialist

The Credentialing Specialist is a professional specialized in credentialing activities, coordinates the credentialing functions, performs analytical and utilizes critical thinking skills when credentialing an applicant, and acts as a liaison between the medical staff, nursing staff and administration within the parameters established by the System Director, Administration, and the officers of the Medical Staff.

PIH Health is a nonprofit, regional healthcare network that serves approximately 3 million residents in the Los Angeles County, Orange County and San Gabriel Valley region.

The fully integrated network is comprised of PIH Health Downey Hospital, PIH Health Good Samaritan Hospital, PIH Health Whittier Hospital, 37 outpatient medical office buildings, a multispecialty medical (physician) group, home healthcare services and hospice care, as well as heart, cancer, digestive health, orthopedics, women’s health, urgent care and emergency services.

The organization is nationally recognized for excellence in patient care and patient experience, and the College of Healthcare Information Management Executives (CHIME) has identified PIH Health as one of the nation’s top hospital systems for best practices, cutting-edge advancements, quality of care and healthcare technology.

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Required Skills

• Writing ability
• Medical terminology (preferred)
• Computer proficiencies in WORD, EXCEL, and working in PDF documents, MDStaff
• Excellent and effective communication skills
• Organized
• Dependable
• Positive professional appearance and attitude
• Regularly demonstrates the ability to exercise independent judgment in times of need and emergency situations
• Familiarity with standards and requirements set forth by CIHQ and Health plans (Medical Group)
• Critical thinking skills
• Analytical skills

Required Experience

Required :

• High school diploma and 5-7 years’ experience as a Credentials Coordinator or credentialing capacity, in a medium to large size medical center with knowledge of medical staff function, credentialing, preparation of meeting minutes, CIHQ, Title XXII, NCQA, health plans and CMA.
• CPCS certified within 1 year of employment
• Knowledgeable with ASM MDStaff software
• Must obtain LA City Fire Card within 6 months of employment (PHGSH Only)

Preferred :

• Bachelor’s degree
• ASM MDStaff Super user certified
28 days ago