Kforce Credentialing Specialist in San Francisco, California

Kforce has a client in search of a Credentialing Specialist in San Francisco, California (CA). Summary: The Credentialing Specialist is responsible for all activities associated with credentialing or re-credentialing providers for the HMO and PPO network. Duties may include processing provider applications, research, verifications, and preparation of files for Credentialing Committee review. One communicates with internal departments and external sources to exchange information and verify data.Essential Job Functions:

  • Gathers data, reviews for completeness and accuracy, analyzes potential problems and recommends appropriate actions; Monitors timeliness and receipt of information and follow up as needed

  • Identifies any issues in the files and refers for further research

  • Enters credentialing data into system and tracks and maintains provider information

  • Performs general office duties such as filing, duplicating, sorting, mail distribution, etc.

  • Works with internal department to exchange provider information and follows up on inconsistencies

  • Identifies procedural and systems problems and brings them to Supervisor's attention; makes recommendations where appropriate

  • Assists with expirables updates licenses and specialty boards

  • High School diploma or GED and/or a combination of equivalent experience

  • Working knowledge of credentialing and health care preferred

  • MS Office, scanning, Adobe Acrobat, cred database Visual Cactus would be a plus

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.Compensation Type:Hours