We are looking for a detail-oriented Credentialing Specialist to join our team in Manhattan Beach, California. The Credentialing Specialist will play a pivotal part in ensuring providers are properly credentialed with Medicare and commercial insurance plans. This position offers an excellent opportunity to expand your expertise and gain hands-on training in medical billing. Responsibilities:• Credentialing processes for 12-13 healthcare providers, ensuring compliance with Medicare and commercial insurance requirements.• Prepare and submit detailed applications for provider credentialing and re-credentialing.• Maintain accurate and up-to-date records of provider credentials and certifications.• Collaborate with insurance carriers to resolve credentialing-related issues efficiently.• Monitor and track credentialing timelines to ensure timely renewals and updates.• Assist in identifying and implementing process improvements for credentialing workflows.• Provide support and training in medical billing processes, as required.• Act as a liaison between providers and insurance companies to address credentialing inquiries.• Ensure adherence to regulatory standards and organizational policies.• Generate reports and documentation related to credentialing activities for internal review.

• Proven experience in credentialing processes, including provider and physician credentialing. • Familiarity with Medicare and commercial insurance credentialing requirements. • Strong organizational skills and attention to detail for managing multiple providers. • Ability to effectively communicate with insurance carriers and healthcare professionals. • Proficiency in tracking and maintaining credentialing records. • Willingness to learn and develop skills in medical billing. • Knowledge of re-credentialing applications and procedures. • Experience with credentialing software or systems is an advantage.

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Manhattan Beach, CA
onsite
Contract / Temporary to Hire
25.12 - 32.13 USD / Hourly
We are looking for a detail-oriented Credentialing Specialist to join our team in Manhattan Beach, California. The Credentialing Specialist will play a pivotal part in ensuring providers are properly credentialed with Medicare and commercial insurance plans. This position offers an excellent opportunity to expand your expertise and gain hands-on training in medical billing. Responsibilities:• Credentialing processes for 12-13 healthcare providers, ensuring compliance with Medicare and commercial insurance requirements.• Prepare and submit detailed applications for provider credentialing and re-credentialing.• Maintain accurate and up-to-date records of provider credentials and certifications.• Collaborate with insurance carriers to resolve credentialing-related issues efficiently.• Monitor and track credentialing timelines to ensure timely renewals and updates.• Assist in identifying and implementing process improvements for credentialing workflows.• Provide support and training in medical billing processes, as required.• Act as a liaison between providers and insurance companies to address credentialing inquiries.• Ensure adherence to regulatory standards and organizational policies.• Generate reports and documentation related to credentialing activities for internal review.
2025-10-17T20:44:12Z