Credentialing Specialist
TrueCare is a trusted healthcare provider serving San Diego and Riverside Counties, offering compassionate and comprehensive care to underserved communities. We are committed to making healthcare accessible to everyone, regardless of income or insurance status. With a focus on culturally sensitive, affordable services, TrueCare aims to improve the health of diverse communities. Our vision is to be the premier healthcare provider in the region, delivering exceptional patient experiences through innovative, integrated care.
The Credentialing Specialist supports the Medical Staff department in ensuring that all healthcare providers are properly credentialed, privileged, and enrolled, and in compliance with federal, state, and organizational credentialing policies.
Responsibilities:
- Collect and review initial credentialing and recredentialing applications.
- Ensure completeness and accuracy of documentation (licenses, certifications, malpractice insurance, etc.)
- Enter and update credentialed staff information in credentialing databases or software (e.g., MD-Staff, CAQH, NPPES)
- Verify provider credentials including education training, licensure, board certification, employment history and references.
- Contact licensing boards, educational institutions, and previous employers for primary source verification.
- Communicate with Licensed Independent Providers (LIPs), staff to obtain missing or expired documents.
- Track expiration dates and ensure timely renewal of licenses, DEA registrations, and other required documents.
- Audit credentialing databases to ensure accuracy and integrity of data.
- Generate and distribute credentialing reports and assist in preparing files for credentialing committee meetings.
- Process Continuing Medical Education (CME) requests.
- Process licensing reimbursement requests.
Qualifications:
- High School Diploma or equivalent.
- 3 to 4 yrs. administrative/office experience preferably in a healthcare setting or relevant credentialing experience.
- Strong organizational skills and attention to detail.
- Computer proficiency with web-based applications and the Microsoft Office suite, including Outlook, Word, Excel and PowerPoint.
Preferred Qualifications:
- Associate degree in business or healthcare administration.
- MD Staff Credentialing Software knowledge.
- National Association Medical Staff Services Certification (NAMSS).
- Certified Provider Credentialing Specialist (CPCS).
- Certified Professional Medical Staff Management (CPMSM).
- Experience in healthcare or working in a Federally Qualified Health Center.
Benefits:
- Competitive Compensation
- Competitive Time Off
- Low-cost health, dental, vision & life insurance
- Tuition Reimbursement, Employee Assistance program
TrueCare is committed to a policy of Equal Employment Opportunity and will not discriminate against an applicant or employee on the basis of race, color, religion, creed, national origin, ancestry, sex, gender, age, physical or mental disability, veteran or military status, genetic information, sexual orientation, gender identity, gender expression, marital status, or any other characteristic protected by applicable federal, state, or local law. Our goal is to promote and ensure authentic inclusion, belonging and support for all team members recruited or employed here. In the spirit of pay transparency, we are excited to share the base salary range for this position.
If you are hired at TrueCare, your final base salary (within the pay range), will be determined based on factors such as education, knowledge, skills, and experience. In addition to those factors, we believe in the importance of pay equity and consider the internal equity of our current team members when determining any final offer. Please keep in mind that the range mentioned above is the full base salary range for the role. Hiring at the maximum of the range would not be typical to allow for future and continued salary growth. We also offer generous benefits and retirement plans.