About the Role: We are seeking a detail-oriented Credentialing Specialist with strong experience in managing provider enrollment and credentialing processes. This role will focus heavily on CAQH profile management and PECOS applications, ensuring timely and accurate completion to maintain compliance with payer and regulatory requirements. Key Responsibilities:<ul><li>Manage the credentialing and re-credentialing process for providers, ensuring accuracy and timeliness.</li><li>Maintain and update CAQH profiles for all providers.</li><li>Complete and submit PECOS applications for Medicare enrollment and revalidation.</li><li>Coordinate with providers, payers, and internal teams to gather necessary documentation.</li><li>Monitor application status, follow up with payers, and resolve discrepancies.</li><li>Maintain accurate records of credentialing activities in internal systems.</li><li>Ensure compliance with federal, state, and payer requirements.</li><li>Provide regular status updates and reporting to leadership.</li></ul>

Qualifications:<ul><li>2+ years of experience in healthcare credentialing.</li><li>Strong knowledge of CAQH and PECOS systems.</li><li>Familiarity with commercial payer and Medicare/Medicaid enrollment processes.</li><li>Excellent attention to detail and organizational skills.</li><li>Strong communication skills to interact with providers and external partners.</li><li>Proficiency in Microsoft Office Suite and credentialing software (if applicable).</li></ul>Preferred Qualifications:<ul><li>Experience credentialing across multiple states.</li><li>Knowledge of NCQA standards.</li><li>Prior experience in a healthcare provider group, MSO, or payer environment.</li></ul>

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Torrance, CA
onsite
Temporary
27.00 - 31.00 USD / Hourly
About the Role: We are seeking a detail-oriented Credentialing Specialist with strong experience in managing provider enrollment and credentialing processes. This role will focus heavily on CAQH profile management and PECOS applications, ensuring timely and accurate completion to maintain compliance with payer and regulatory requirements. Key Responsibilities:<ul><li>Manage the credentialing and re-credentialing process for providers, ensuring accuracy and timeliness.</li><li>Maintain and update CAQH profiles for all providers.</li><li>Complete and submit PECOS applications for Medicare enrollment and revalidation.</li><li>Coordinate with providers, payers, and internal teams to gather necessary documentation.</li><li>Monitor application status, follow up with payers, and resolve discrepancies.</li><li>Maintain accurate records of credentialing activities in internal systems.</li><li>Ensure compliance with federal, state, and payer requirements.</li><li>Provide regular status updates and reporting to leadership.</li></ul>
2025-08-29T21:04:01Z