Credentialing Specialist

This is a full-time, benefit eligible partial remote position located in San Diego. Must be local or willing to relocate. The position is Monday - Friday; business hours either 7am-3:30pm or 8am-4:30pm.

Why join Scripps Health?

At Scripps Health, your ambition is empowered and your abilities are appreciated:

• Nearly a quarter of our employees have been with Scripps Health for over 10 years.
• Scripps is a Great Place to Work Certified company for 2025.
• Scripps Health has been consistently ranked as a top employer for women, millennials, diversity, and as an overall workplace by various national publications.
• Becker's Healthcare ranked Scripps Health on its 2024 list of 150 top places to work in health care.
• We have transitional and professional development programs to create a learning environment that enables you to thrive in your specific field as well as in your overall career.
• Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics, geriatrics, obstetrics and gynecology, and gastroenterology.

This position is accountable for primary source verification and analysis of all applicant information and reappointment information in accordance with Accreditation and Licensure Standards, California State and Federal Laws, Medical Staff Bylaws and related policies. The position interfaces with applicants, medical staff officers, leadership and department staff. Responsible for maintaining confidentiality of all information.

Required Education/Experience/Specialized Skills:

• High School Diploma/GED.
• At least one year of credentialing experience in an integrated health care delivery system inclusive of hospital and health plan credentialing.
• Knowledge of NCQA, Joint Commission, NPDB guidelines, applicable State and Federal regulations.

Required Certification/Registration:

• CPCS or CPMSM within 2 years

Preferred Education/Experience/Specialized Skills/Certification:

• Bachelor's Degree in Related Field.
• 2-3 Years of post-high school administrative role requiring a high degree of analytic ability, coordination of processes in a fast paced environment.
• Experience with the MD Staff credentialing software or similar.
• Basic knowledge of medical terminology.
• Experience in credentialing in a CVO or MSO setting.
• Familiarity with TJC, NCQA, and/or AAAHC.