The successful candidate will be responsible for ensuring that our organization meets all credentialing and quality standards in healthcare. The QA Specialist will perform a range of duties, including reviewing and analyzing credentialing files and applications, ensuring compliance with regulatory requirements, and monitoring the ongoing performance of
healthcare providers.
Key Responsibilities:
- Review and analyze healthcare provider credentialing applications, files, and supporting documents to ensure accuracy and completeness
- Verify that all healthcare providers have current and valid licenses and certifications, and meet all regulatory and accrediting agency requirements
- Conduct ongoing monitoring and audits of healthcare providers to ensure compliance with credentialing and quality standards
- Provide support and guidance to healthcare providers on credentialing and quality-related matters
- Collaborate with internal teams to develop and implement credentialing and quality assurance policies and procedures
- Maintain accurate and up-to-date credentialing and quality assurance records and documentation
- Participate in external audits and surveys related to credentialing and quality assurance
- Provide regular reports and analysis on credentialing and quality assurance performance metrics
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