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Credential Stream Jobs in Arizona (NOW HIRING)

Epic Staffing Group

$4K/wk

Explore additional income streams and secure your future * Simplified Employee Pension Plan ... Our team will manage your credentialing portfolio: state licenses, renewals, and applications

American Dental Companies

Associate Dentist

Surprise, AZ · On-site

$180K - $230K/yr

Step into a bustling office with a loyal following and a massive stream of new patients. This ... Credentials: Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. * Licensure:

American Dental Companies

Associate Dentist

Surprise, AZ · On-site

$180K - $230K/yr

Step into a bustling office with a loyal following and a massive stream of new patients. This ... Credentials: Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. * Licensure:

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Credential Stream information

What are Credential Stream jobs?

Credential Stream jobs refer to positions that require specific qualifications or credentials, such as licenses, certifications, or formal education, to be eligible for employment. These jobs often exist in regulated professions like healthcare, engineering, law, or skilled trades. Employers verify that candidates possess the necessary credentials to ensure compliance with industry standards and regulations. Credential Stream processes are commonly used in immigration programs to assess the eligibility of foreign workers for skilled positions. Understanding the required credentials is essential for anyone pursuing a career through this stream.

What are some common challenges faced by professionals working in Credential Stream roles, and how can they be addressed?

Professionals in Credential Stream roles often manage sensitive data, oversee credentialing processes, and ensure compliance with regulatory standards. Common challenges include keeping up with frequently changing compliance requirements, handling a high volume of documentation, and coordinating with multiple departments or external agencies. To address these, it is helpful to develop strong organizational skills, stay updated on industry regulations, and utilize credentialing software to streamline workflows. Regular communication with stakeholders and ongoing training can also help mitigate these challenges and ensure accuracy in credential management.

What are the key skills and qualifications needed to thrive as a Credentialing Specialist, and why are they important?

To thrive as a Credentialing Specialist, you need a solid understanding of credentialing processes, attention to detail, and knowledge of industry regulations, often supported by a degree in healthcare administration or a related field. Familiarity with credentialing software (such as CAQH ProView or VerityStream), databases, and sometimes certification like CPCS is commonly required. Outstanding organizational skills, effective communication, and the ability to manage confidential information make someone stand out. These competencies ensure accurate provider verification, regulatory compliance, and smooth healthcare operations.

What is the difference between Credential Stream vs Medical Assistant?

AspectCredential StreamMedical Assistant
Required credentialsCertification programs, state-specific licensesCertified Medical Assistant (CMA), Registered Medical Assistant (RMA)
Work environmentHealthcare facilities, clinics, hospitalsClinics, outpatient care, hospitals
Industry usageHealthcare credentialing and certificationPatient care, administrative and clinical tasks
Search intentCredentialing, certification, licensingMedical assisting, clinical duties, certification

Credential Stream and Medical Assistant roles are closely related in healthcare. Credential Stream focuses on certification and licensing processes, while Medical Assistants perform clinical and administrative tasks in healthcare settings. Both require specific credentials, but Credential Stream emphasizes the certification pathway, whereas Medical Assistants are the practitioners executing patient care.

What are popular job titles related to Credential Stream jobs in Arizona? For Credential Stream jobs in Arizona, the most frequently searched job titles are:
What job categories do people searching Credential Stream jobs in Arizona look for? The top searched job categories for Credential Stream jobs in Arizona are:
Credential Stream jobs near you
Provider Enrollment & Credentialing Specialist

Provider Enrollment & Credentialing Specialist

Southwest Autism Research and Resource Center

Phoenix, AZ • On-site

$24/hr

Full-time

Medical, Dental, Vision, Retirement, PTO

Posted 2 days ago

Job description

PROVIDER SERVICES and CREDENTIALING SPECIALIST
On-site
Phoenix, AZ

As a provider services team member, you have a deep understanding of client funding sources, including insurance funding and ensure funding related information is documented accurately and timely. Additionally, you can identify errors and corrections that are needed to ensure the accuracy of records and billing. This position will provide additional support to obtain authorizations, reauthorizations, support with denials, and adjustments needed to authorizations. In addition, this position will be accountable for establishing and maintain provider credentialing.

Your Role at SARRC
Funding Documentation amp; Accuracy
  • Deep Understanding of Funding Sources: Demonstrate a comprehensive knowledge of various client funding sources, including private insurance plans, AHCCCS/Medicaid, and other relevant funding streams for behavioral health services.
  • Data Integrity amp; Auditing: Accurately and timely document all client funding and insurance-related information in relevant systems.
  • Compliance amp; Record Keeping: Ensure all documentation adheres to payer, state, and federal compliance standards.
Authorization Management amp; Benefit Verification
  • Authorization Processing: Efficiently manage the end-to-end process for obtaining initial authorizations and timely reauthorizations for client services.
  • Denial and Appeal Support: Provide dedicated support in investigating and processing denials related to authorizations, collaborating with clinical and billing teams to compile necessary documentation for appeals and adjustments.
  • Authorization Adjustments: Process and track necessary adjustments to existing authorizations based on changes in service intensity or client needs.
  • Verifications: Navigate initial benefit verification for clients with multiple plans, denials, and requests for change of provider or insurance during an authorization period as instructed by Manager.
Provider Credentialing amp; Records Management
  • Credentialing Expertise: Be the primary owner of the provider credentialing process.
    • Establish and maintain comprehensive provider records, ensuring all licenses, certifications, and required documentation are current and compliant.
    • Manage the application and re-credentialing process with all relevant payers (e.g., insurance companies, AHCCCS).
  • System Maintenance: Maintain accurate and up-to-date credentialing information within all internal and external databases.
Required Qualifications
  • High School Diploma or GED.
  • Minimum of two (2) years’ experience within a healthcare administration environment.
  • Technical Knowledge:
    • Knowledge of provider credentialing.
    • Understanding of insurance authorizations procedures and policies.
    • Knowledge of insurance guidelines, including:
      • Commercial Payers
      • Arizona Medicaid (AHCCCS)
      • EAP services
    • Knowledge of CPT, ICD-10, HCPCS coding.
    • Experience with a practice management software.
    • CAQH
    • NPPES
Preferred Qualifications
  • Associate’s degree.
  • Experience within behavioral health, specifically ABA.
Salary
Starts at $24/hr
Robust Benefits Package
  • Up to 16 days per year paid time off and 8 paid holidays
  • Medical, dental and vision insurance (majority of coverage paid for by SARRC)
  • 401(k) with 50% company match up to 6%
  • Mileage reimbursement
  • Professional development annual benefit of $1000
Our Story
Established in 1997 by two mothers of children with autism and their developmental pediatrician, SARRC is an internationally recognized nonprofit with a mission to advance research and provide a lifetime of support for individuals with autism and their families. As the state of Arizona’s largest nonprofit serving the autism community, SARRC conducts innovative research, provides evidence-based practices, disseminates effective training, and builds inclusive communities.

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