AMBULATORY CLINIC CREDENTIALING SPECIALIST - Tri City Healthcare District

Tri-City Medical Center has served San Diego County’s coastal communities of Carlsbad, Oceanside and Vista, as well as the surrounding region for more than 60 years and is one of the largest employers in North San Diego County. Tri-City is administered by the Tri-City Healthcare District, a California Hospital District. As a full-service acute care public hospital with over 500 physicians practicing in over 60 specialties, Tri-City is vital to the well-being of our community and serves as a healthcare safety net for many of our citizens. The hospital has received a Gold Seal of Approval® from the Joint Commission showcasing a commitment to safe and effective patient care for the residents of the community. 

Tri-City Medical Center prides itself on being the home to leading orthopedic, spine and cardiovascular health services while also specializing in world-class robotic surgery, cancer and emergency care. Tri-City’s Emergency Department is there for your loved ones in their time of need and is highly regarded for our heart attack and stroke treatment programs. When minutes matter Tri-City is your source for quality compassionate care close to home. Tri-City partners with over 90 local non-profit and community organizations as part of our COASTAL Commitment initiative. Together we are helping tackle some of our communities’ pressing health and social needs.

Position Summary:

This position is responsible for performing credentialing activities including maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare and Medicaid.

Major Position Responsibilities:

The position characteristics reflect the most important duties, responsibilities and competencies considered necessary to perform the essential functions of the job in a fully competent manner. They should not be considered as a detailed description of all the work requirements of the position. The characteristics of the position and standards of performance may be changed by TCMC with or without prior notice based on the needs of the organization.

• Maintains a safe, clean working environment, including unit based safety and infection control requirements.
• Request all necessary credentialing documentation from onboarding providers and maintaining all current copies of credentialing documentation.
• Complete all attestations through the various required entities.
• Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, compliance with federal, state, and local regulations, guidelines, policies and standards.
• Enters, updates and maintains data from provider applications into credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.
• Communicates clearly with internal and external customers and provides timely responses regarding credentialing and privileging issues.
• Perform other duties as needed.

Qualifications:

• Three (3) years medical and professional credentialing experience, required.
• Strong organizational skills, including ability to prioritize daily workload to meet multiple tasks and deadlines, required.
• Ability to communicate effectively utilizing both written and verbal skills, required.
• Ability to provide excellent customer service, required.
• Ability to interpret, adapt and apply guidelines and procedures. Knowledge of Joint Commission standards and regulatory requirements, required.

Education:

• High-school diploma or GED, required.
• Associate’s degree, preferred.

Certification:

• CPCS, preferred.

Each new hire candidate who is offered employment must pass a physical evaluation, urine drug screen and pre-employment background checks before starting work.

*Salary/Hourly Wage range based on experience.

To protect the health of patients and staff, and to comply with the new State of California mandates, all job offers are contingent on the successful engagement in the TCMC COVID-19 vaccination program (fully vaccinated with documented proof or approved exception/deferral.)

TCHD is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, sexual orientation, or gender identity/expression), age, marital status, status as a protected veteran, among other things, or status as a qualified individual with a disability.