Medical Staff Office Specialist II (KFH/HP)

$55,600 - $71,830/Yr

Kaiser Permanente - Fontana, CA

Full-time - Entry Level

Fontana, CA

10,001+ employees

Ambulatory Health Care Services

About the position

The Medical Staff Office Specialist II plays a crucial role in the credentialing and privileging processes within the healthcare setting. This position involves reviewing primary source information, managing vendor relationships, and serving as a point of contact for external queries regarding practitioner status. The specialist evaluates applications, supports quality assurance, and assists in maintaining data systems, ensuring compliance with internal policies and external regulations.

Responsibilities

• Request and review primary source information and verifications with limited guidance.
• Identify and plan for resolution of standard gaps in vendor relationships and escalate as needed.
• Serve as the main point of contact for external queries regarding practitioner status.
• Evaluate applications and supporting documents for completeness and compliance.
• Participate in surveys and audits of credentialing entities.
• Support cost-effective due process and identify basic adverse actions/issues.
• Review data to aid in auditing and reconciliation of data.
• Develop standard informational documents and maintain working relationships with key stakeholders.
• Assist in quality assurance and improvement by evaluating practitioner sanctions and complaints.
• Process provider enrollment and communicate relevant information to appropriate parties.

Requirements

• Associate's degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field.
• Minimum one year of experience in clinical credentialing, accreditation and regulation, licensing, health care, quality, or a directly related field, or two years of experience in a directly related field.

Nice-to-haves

• Knowledge of project management principles.
• Familiarity with credentialing IT application software.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• 401k retirement plan
• Paid time off
• Flexible scheduling