Credentialing Coordinator

APLA Health’s mission is to achieve health care equity and promote well-being for the LGBT and other underserved communities and people living with and affected by HIV. We are a nonprofit, federally qualified health center serving more than 14,000 people annually. We provide 20 different services from 15 locations throughout Los Angeles County, including: medical, dental, and behavioral health care; PrEP counseling and management; health education and HIV prevention; and STD screening and treatment. For people living with HIV, we offer housing support; benefits counseling; home health care; and the Vance North Necessities of Life Program food pantries; among several other critically needed services. Additionally, we are leaders in advocating for policy and legislation that positively impacts the LGBT and HIV communities, provide capacity-building assistance to health departments across the country, and conduct community-based research on issues affecting the communities we serve. For more information, please visit us at aplahealth.org.

 We offer great benefits, competitive pay, and great working environment! 

We offer:

• Medical Insurance
• Dental Insurance (no cost for employee)
• Vision Insurance (no cost for employee)
• Long Term Disability
• Group Term Life and AD&D Insurance
• Employee Assistance Program
• Flexible Spending Accounts
• 12 Paid Holidays
• 3 Personal Days
• 10 Vacation Days
• 12 Sick Days
• Metro reimbursement or free parking
• Employer Matched 403b Retirement Plan

This is a great opportunity to make a difference!

This position will pay $26.80 – $31.39 hourly. Salary is commensurate with experience.

POSITION SUMMARY:

Under the guidance of the Associate Director of Human Resources, the Credentialing Coordinator is responsible for the timely gathering, reviewing and compiling of provider application information to be submitted to the appropriate credentialing service. Ensures interpretation and compliance with the appropriate credentialing regulations. Acts as the liaison between the credentialing services and APLA Health & Wellness.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Responsible for the timely gathering and submitting for processing to IPA’s and health plans on an ongoing basis, all credentialing and re-appointment applications.
• Sit with provider to complete credentialing application when necessary.
• Tracks all pending applications and notifies the Associate Director of Human Resources of any challenges with obtaining provider information.
• Responsible for reviewing and verifying all credentialing documentation for providers, confirming consistency and accuracy based on regulatory requirements.
• Coordinates review and approval of clean files by the Medical Director, Behavioral Health Director and Dental Director.
• Prepares credentialing documentation for the Risk Management and Compliance Committee.
• Prepares credentialing documents for approval from the Medical Director, Dental Director, or Behavioral Health Director, CEO and the Board.
• Assists Associate Director with credentialing audits.
• Maintains accuracy and integrity of the CAQH and credentialing tracking databases.
• Maintains provider credentialing files in Paycom and conducts internal file audits to ensure accuracy and efficiency throughout the credentialing process.
• Responsible for obtaining monthly reports from IPA’s and health plans.
• Responsible for scanning, uploading and filing of all credentialing documents to ensure a paperless environment.
• Coordinate any new training from health plans with provider.
• Obtain privileging and competency documentation for clinical staff.
• Works with internal and external customers on day-to-day credentialing and privileging issues and requests as they arise.
• Complete provider directory updates as needed.
• Conduct new hire credentialing orientation.

OTHER DUTIES MAY BE ASSIGNED TO MEET BUSINESS NEEDS.

REQUIREMENTS:

Training and Experience:

AA degree and 2 years credentialing experience in a healthcare environment or HS diploma and 4 years’ experience. Must be detailed oriented and possess strong organizational skills.  Possess effective oral and written communication skills, proficient in the use of Microsoft Office: Word, and Excel.  Previous experience with Paycom or other HRIS application a plus.

Knowledge of:

CAQH preferred.

Ability to:

Work with people of diverse cultural, educational, social and economic backgrounds.  Must possess the ability to follow instructions and exercise good judgment.  Ability to thrive in a fast paced dynamic work environment and meet all deadlines.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

SPECIAL REQUIREMENTS:

Must possess a valid California driver’s license; proof of auto liability insurance; and have the use of a personal vehicle for work related purposes. May be required to drive to other APLA sites to obtain credentialing information.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS:

This is primarily an office position that requires only occasional bending, reaching, stooping, lifting and moving of office materials weighing 25 pounds or less. The position requires daily use of a personal computer and requires entering, viewing, and revising text and graphics on the computer terminal and on paper.

Equal Opportunity Employer: minority/female/disability/transgender/veteran.

COVID-19 Vaccination and Booster or Medical/ Religious Exemption required.

https://www.paycomonline.net/v4/ats/web.php/jobs/ViewJobDetails?job=134154&clientkey=A5559163F67395E0A2585D2135F98806