Physician Credentialing Specialist
Community First Health PlansPOSITION SUMMARY/RESPONSIBILITIES
Responsible for provider oversight of the verification process of provider credentialing to ensure compliance with Community First Health Plans (CFHP) policies and procedures. Oversees the daily activities associated with the efficient operation of the provider credentialing process, in cooperation with the Network Management department, Quality Management department and the Medical Director.
EDUCATION/EXPERIENCE
High school diploma/GED required. Three years of healthcare environment office experience required. Two years of credentialing experience preferred. Exceptional organizational skills, accuracy in administrative/secretarial duties, medical terminology, knowledge of spreadsheets and word processing software are required. Knowledge of NCQA standards, state licensing board and other state requirements and regulations with reference to provider credentialing preferred.
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