66 results for Credentialing Specialist jobs

Credentialing Specialist

Somerville, NJ
onsite
Temporary
25 - 30 USD / Hourly
We are looking for a detail-oriented Credentialing Specialist to join our team. In this long-term contract position, you will play a vital role in ensuring healthcare practitioners meet all credentialing and privileging requirements according to state, federal, and accreditation guidelines. This is an excellent opportunity to showcase your organizational skills and contribute to maintaining compliance and efficiency within the credentialing process. Responsibilities:<ul><li>Conduct thorough primary source verification to confirm education, licenses, and training credentials of healthcare practitioners.</li><li>Review and audit applications for accuracy and completeness, ensuring all required information is provided.</li><li>Manage and maintain credentialing records, privileging documentation, and enrollment files with precision.</li><li>Oversee provider enrollment processes for Medicaid, CAQH, and other healthcare systems, ensuring compliance with established procedures.</li><li>Upload and link critical documents in credentialing systems while maintaining accurate data entry.</li><li>Regularly update and audit on-call schedules to ensure accuracy and reliability.</li><li>Collaborate with physicians, advanced practice providers, hospital staff, and external organizations to address credentialing matters.</li><li>Ensure databases are consistently updated and maintained for seamless access and reporting.</li><li>Handle confidential information with discretion and professionalism, addressing urgent matters promptly.</li></ul>
2026-03-13T00:00:00Z

Credentialing Coordinator

Fort Wayne, IN
onsite
Contract / Temporary to Hire
19.95 - 23.1 USD / Hourly
We are looking for a motivated Credentialing Coordinator to oversee the credentialing process for healthcare providers, ensuring timely and accurate submission of applications and documentation. This role is crucial for maintaining compliance with industry standards and supporting physicians in delivering quality patient care. As a Contract to permanent position, this opportunity offers a pathway to long-term career growth. Responsibilities: • Manage the end-to-end credentialing process for physicians, including application preparation, documentation collection, and submission to relevant entities. • Ensure the accuracy and completion of all credentialing documents, verifying certifications, licenses, and compliance with regulatory standards. • Monitor healthcare regulations and accreditation requirements to maintain compliance throughout the credentialing process. • Resolve issues or discrepancies that arise during the credentialing process, collaborating with healthcare providers and agencies to find solutions. • Keep detailed and organized records of credentialing statuses, deadlines, and associated documentation. • Communicate effectively with physicians, insurance companies, and healthcare facilities to facilitate a smooth credentialing experience. • Assist with recredentialing applications and updates to ensure providers maintain their active status. • Utilize credentialing databases and software tools to track progress and generate reports. • Support delegated credentialing processes for organizations that oversee multiple providers. • Provide guidance to physicians on navigating the credentialing requirements of insurance networks and healthcare facilities.
2026-02-17T00:00:00Z

Credentialing Assistant

Minneapolis, MN
onsite
Permanent
41600 - 50000 USD / Yearly
We are looking for a highly organized and detail-oriented Credentialing Assistant to join our client's team in Minneapolis, MN. In this role, you will play a vital part in supporting healthcare providers by serving as a liaison between providers and medical staff to manage credentialing processes and ensuring accurate communication, timely renewals, and compliance with industry standards. Ideal candidate brings excellent communication skills, keen attention to detail, the ability to multitask effectively, and a commitment to maintaining accuracy in documentation. Responsibilities:• Accurately compile and maintain credentialing records for healthcare providers, ensuring all documentation is current and compliant.• Monitor expiration dates for certifications, licenses, and other required documents, updating systems promptly to avoid lapses.• Assist providers with enrollment in life support courses and create reminders to ensure timely renewals.• Prepare and submit credentialing applications for hospital and billing purposes, tracking progress and providing follow-ups as needed.• Facilitate onboarding processes for students and residents, including managing observation requests.• Provide support for providers undergoing name changes, ensuring all credentials and documentation are updated accordingly.• Offer backup administrative assistance for educational events and other departmental activities.• Collaborate with the credentialing team to ensure adherence to organizational and regulatory standards.• Maintain accurate digital files and Excel spreadsheets to track credentialing information.• Uphold office safety and compliance by adhering to company guidelines and policies.
2026-03-05T00:00:00Z

Credentialing Manager

Brookfield, WI
onsite
Permanent
70000 - 85000 USD / Yearly
Robert Half is partnering with a Wisconsin headquartered healthcare organization in the recruiting for a Credentialing Manager to lead their credentialing operations within their facilities and external provider enrollment and credentialing. This role is responsible for overseeing the full credentialing process for medical staff, ensuring compliance with regulatory and accreditation requirements, and optimizing workflow for timely and accurate provider enrollment. The ideal candidate will bring years of progressive credentialing experience in healthcare, strong leadership skills, and deep knowledge of industry regulations and standards. This is a permanent placement opportunity offering competitive salary, benefits, generous paid time off, and flexible schedule with fully remote option. Responsibilities:<ul><li>Lead the credentialing team to process provider applications, verifications, and re-credentialing activities in accordance with regulatory, payer, and facility requirements </li><li>Develop, implement, and maintain policies, procedures, and workflow improvements to ensure efficient, compliant credentialing operations </li><li>Oversee initial and ongoing verification of practitioner credentials (education, licensure, certifications, work history, malpractice history, etc.) </li><li>Stay current with state, federal, and accrediting body requirements (e.g., NCQA, Joint Commission) and serve as internal subject matter expert for compliance </li><li>Manage relationships and communications with providers, insurance payers, and internal stakeholders to resolve credentialing issues and expedite enrollment</li><li>Prepare for and participate in audits, surveys, and quality assurance reviews; ensure proper documentation and recordkeeping </li><li>Provide regular reporting and analytics to senior leadership regarding credentialing metrics, provider enrollment status, and workflow efficiency </li><li>Hire, train, and mentor credentialing staff; foster a culture of accountability and continuous improvement </li></ul>
2026-03-05T00:00:00Z

Eligibility Specialist

Houston, TX
remote
Contract / Temporary to Hire
22.8 - 26.4 USD / Hourly
We are seeking an experienced and detail‑oriented RCM Reimbursement Specialist focused on Appeals and Denials to join our team on a contract-to-hire basis. This fully remote role is essential in maximizing reimbursement by following up on outstanding insurance balances, resolving unpaid claims, and managing appeals through multiple levels.The ideal candidate thrives in a fast‑paced environment, is meticulous in their work, and has deep expertise in medical billing, payer processes, and denial management. Responsibilities<ul><li>Resolve aged claims and appeals lacking payer responses through payer portals and outbound calls.</li><li>Identify claims requiring first, second, or third‑level appeals.</li><li>Support teammates with special projects and denial work queue management.</li><li>Prioritize an assigned work queue to ensure timely follow‑up while maximizing reimbursement opportunity.</li><li>Identify non‑payment trends and partner with Revenue Cycle leadership to escalate groups of claims to Market Access.</li><li>Investigate denial and non‑payment trends identified by Revenue Cycle Analytics and collaborate cross‑functionally to propose and implement solutions.</li><li>Communicate opportunities to improve upstream processes that may prevent future denials.</li><li>Engage patients when their involvement is required during the appeal process.</li><li>Collaborate professionally with Revenue Cycle team members and respond promptly to requests requiring assistance.</li></ul>
2026-03-13T00:00:00Z

Eligibility Specialist

Port Saint Lucie, FL
onsite
Contract / Temporary to Hire
19 - 21 USD / Hourly
We are looking for a detail-oriented Eligibility Specialist to join our team in Port St Lucie, Florida. In this Contract to permanent position, you will play a critical role in managing eligibility documentation and ensuring compliance for children in out-of-home care. This role requires a strong understanding of Medicaid processes, insurance follow-up, and preauthorization procedures. Responsibilities: • Prepare and compile comprehensive documentation to facilitate Title IV-E determinations for children entering out-of-home care. • Enroll newly eligible Medicaid recipients into the Sunshine Child Welfare Specialty Plan. • Identify and refer children potentially eligible for Social Security benefits to the Master Trust Specialist. • Process and submit applications for all children under the supervision of CCKids. • Monitor and manage Title IV-E determinations to prevent expiration and ensure timely re-determinations. • Review, approve, and organize pre-adoption files submitted by Adoption Case Managers. • Handle agreements, update placements and services, and coordinate with case managers on adoption case assignments and finalizations. • Process new Title IV-E applications for children placed in adoption settings promptly and accurately. • Assist case management teams in obtaining eligibility documentation for adoption cases or future eligibility reviews. • Address inquiries about Medicaid billing, primary care physician changes, and related matters from foster parents, caregivers, case managers, and investigators.
2026-03-13T00:00:00Z

Medical Eligibility Specialist

Long Beach, CA
onsite
Contract / Temporary to Hire
18.2115 - 23 USD / Hourly
A Medical Center in Long Beach is in the immediate need of Medical Eligibility Specialist. The Medical Eligibility Specialist will play a vital role in ensuring accurate financial screening, eligibility and insurance verification for incoming patients. The Medical Eligibility Specialist ideally will have strong experience in eligibility, microsoft excel and medi-cal insurance. Responsibilities:• Conduct financial screenings for incoming clients to determine eligibility and financial liability.• Verify Medi-Cal coverage and other insurance eligibility to ensure proper documentation and accurate billing.• Maintain and update client financial records in electronic health record systems.• Organize and track annual re-evaluations of client financial information.• Follow up with clinical staff to ensure completion of required documentation for financial folders.• Collect and manage client documents, such as Medi-Cal cards, social security cards, and identification cards.• Create and oversee electronic insurance folders, including adjustments, claims, and explanation of benefits (EOBs).• Audit financial folders upon client discharge to ensure compliance and accuracy.
2026-03-13T00:00:00Z

Background Verification Specialist

San Ramon, CA
remote
Contract / Temporary to Hire
24 - 25 USD / Hourly
Robert Half is seeking an organzied and proactive Verification Specialist to join our team in San Ramon, CA. In this contract-to-permanent position, you will play a vital role in providing comprehensive support for verification processes, collaborating closely with internal teams and external clients. Your expertise will be essential in maintaining high service standards, developing training resources, and troubleshooting system issues. You must be local to California to be considered. Verification Specialist Responsibilities:• Utilize customer service reports to enhance verification processes, including creating new procedures, improving communication, and elevating service levels.• Develop and maintain documentation related to customer service tasks, such as processes and policies.• Design and deliver training for internal teams on compliance, operational, and technical aspects of verification.• Manage and update training materials on internal platforms to ensure accessibility and relevance.• Facilitate training sessions for end users, both individually and through group calls, on systems and procedures.• Respond to verification inquiries, conducting research, tracking actions, and maintaining documentation in case management systems.• Act as the primary troubleshooter, monitoring and resolving system or vendor-related issues promptly and professionally.• Collaborate with verification team members and corporate departments to ensure adherence to best practices and compliance with regulations.• Ensure accurate and timely processing of verifications to meet business objectives and exceed expectations. If you are interested in this Verification Specialist position, please submit your resume ASAP!
2026-03-12T00:00:00Z

Credit and Collections Specialist

Canonsburg, PA
onsite
Permanent
60000 - 80000 USD / Yearly
Our company, a leading manufacturing organization, is seeking a dedicated and detail-oriented Credit Specialist to join our finance team. In this essential role, you will play a key part in safeguarding our company’s financial health by evaluating the creditworthiness of new and existing customers, monitoring outstanding accounts, and collaborating with sales and operations to ensure timely payments.Responsibilities:<ul><li>Evaluate and assess the creditworthiness of new and existing customers using financial statements, trade references, and credit reports</li><li>Establish and monitor customer credit limits in accordance with company policies</li><li>Review and approve orders on credit hold, partnering closely with sales and customer service</li><li>Monitor accounts receivable aging, follow up on overdue accounts, and help resolve payment discrepancies</li><li>Recommend and implement credit limits, payment terms, and collections strategies for delinquent accounts</li><li>Maintain accurate records of credit activity and collection efforts</li><li>Prepare credit and collections reports for management</li><li>Support audits and process improvements as needed</li></ul>
2026-03-09T00:00:00Z

Credit and Collections Specialist

Canonsburg, PA
onsite
Permanent
60000 - 80000 USD / Yearly
Our company, a leader in the manufacturing sector, is seeking a motivated and detail-oriented Collections Specialist to join our finance team. In this critical role, you will ensure the timely collection of outstanding accounts receivable and support our company’s financial stability by actively managing customer accounts.Responsibilities:<ul><li>Monitor and manage accounts receivable portfolio, identifying overdue accounts and initiating collection efforts</li><li>Contact customers via phone, email, and written communication to resolve past-due balances</li><li>Investigate and resolve payment discrepancies and customer billing issues in a timely and professional manner</li><li>Collaborate with sales, customer service, and credit teams to resolve account issues and expedite collections</li><li>Recommend accounts for further action when necessary, including escalation or potential legal proceedings</li><li>Maintain detailed records of collection activity and customer communications</li><li>Provide regular updates and reports on collection status and aged receivables to finance management</li><li>Support process improvements to enhance collections efficiency</li></ul>
2026-03-09T00:00:00Z

Credit/Collections Specialist

Burlington, VT
onsite
Permanent
50000 - 60000 USD / Yearly
We are looking for a skilled Credit/Collections Specialist to join our clients team in Burlington, Vermont. This role is ideal for someone who excels in fast-paced environments and values collaboration, organization, and effective communication. As part of the team, you will play a key role in managing customer accounts, ensuring compliance with policies, and delivering exceptional service. Responsibilities:• Manage customer accounts by monitoring payment history, addressing overdue balances, and initiating collection efforts as needed.• Communicate clearly with customers to resolve payment issues and provide clear explanations of policies and guidelines.• Analyze usage data and financial reports to develop tailored payment plans and budget solutions.• Ensure compliance with regulatory standards and company policies in all interactions and decisions.• Perform field service disconnections when necessary, using appropriate tools safely and efficiently.• Collaborate with team members to prioritize tasks and adapt to changing workflow demands.• Utilize Microsoft Office and other software applications to maintain accurate records and generate reports.• Remain calm and attentive to details in challenging situations, maintaining a customer-focused approach.• Apply strong analytical and problem-solving skills to identify and address account discrepancies.• Demonstrate discretion and attention to detail in all aspects of the role.
2026-03-04T00:00:00Z

Credit/Collections Specialist

Sparks, NV
onsite
Permanent
60000 - 65000 USD / Yearly
Brad Stewart with Robert Half Finance and Accounting is recruiting to fill a Credit/Collections Specialist with a well respected, well established wholesale company in Reno. This business-to-business collections position is full time, on-site and part a great company. Day to day the position entails being a part of a team of 4:<ul><li>Making calls and sending emails for an assigned customer base</li><li>Reviewing credit applications</li><li>Answering customer questions regarding billing and payments</li></ul>
2026-02-27T00:00:00Z

Administrative and Credentialing Assistant

Grand Rapids, MI
onsite
Temporary
21.85 - 25.3 USD / Hourly
We are looking for a detail-oriented Administrative and Credentialing Assistant to join our team in Grand Rapids, Michigan. This long-term contract position requires a proactive individual with attention to detail to handle credentialing processes, manage documentation, and ensure compliance with industry standards. The ideal candidate will thrive in a structured environment and bring strong analytical and communication skills to support organizational goals effectively. Responsibilities: • Review and process payor submissions to ensure accuracy and compliance. • Coordinate the credentialing of physicians by verifying their qualifications and certifications against relevant databases. • Maintain detailed records and documentation for membership and credentialing activities. • Facilitate the signing of necessary documents to support new member onboarding. • Adhere to established processes and draw analytical conclusions based on procedural guidelines. • Conduct recredentialing tasks, ensuring all required certifications and program completions are verified. • Cross-check information using various databanks, including the American Medical Association database. • Collaborate with team members to uphold quality standards in documentation and credentialing processes. • Communicate effectively in written and verbal forms to address credentialing inquiries and resolve issues. • Support physician and provider credentialing with a focus on accuracy and thoroughness.
2026-03-05T00:00:00Z

Credit Specialist

Louisville, KY
onsite
Permanent
55000 - 60000 USD / Yearly
We are looking for a Credit Specialist to join our team in Louisville, Kentucky. In this role, you will be responsible for assessing and maintaining the creditworthiness of clients, ensuring timely payments, and supporting overall financial stability. This position requires strong analytical skills and the ability to collaborate effectively with sales and management teams. Responsibilities: • Monitor accounts receivable and analyze payment trends to ensure customers comply with their credit limits and payment terms. • Conduct research and reconcile discrepancies by issuing corrective invoices, processing adjustments, and managing debit and credit memos. • Participate in credit review meetings with senior leadership to provide updates and recommendations. • Travel to customer sites or plant locations as needed to address credit-related matters. • Complete administrative tasks and contribute to special projects as assigned. • Obtain and review Dun & Bradstreet reports, supplier references, and other relevant data to recommend customer credit limits and terms.
2026-03-03T00:00:00Z

Medical Billing Specialist

Basking Ridge, NJ
onsite
Contract / Temporary to Hire
25.3365 - 29.337 USD / Hourly
Our client is seeking an experienced Medical Billing Specialist to join their healthcare team in Basking Ridge, New Jersey. In this role, you will handle Medicare billing processes for skilled nursing facilities, ensuring compliance and accuracy in claims and collections. This is a Contract to permanent position offering an opportunity to contribute to the financial operations of senior living communities. Medicaid Medical Biller Responsibilities:• Manage end-to-end accounts receivable processes and collections for skilled nursing facilities.• Submit, monitor, and resolve Medicare Part A claims, including corrections, status checks, and eligibility verifications.• Handle billing for Medicare Part B, hospice care, and outpatient services with attention to payer status.• Investigate and follow up on unpaid, underpaid, or rejected claims, including appeals and reconsiderations.• Maintain accurate coding and documentation to ensure compliance with Medicare regulations.• Collaborate with clinical, business office, and revenue cycle teams across multiple facilities to optimize billing operations.• Monitor accounts receivable aging and escalate high-risk accounts when necessary.• Utilize systems such as PointClickCare, Inovalon, and MatrixCare to manage billing activities.• Ensure timely and accurate submissions by verifying all claim data for completeness.• Coordinate with nursing leadership and business offices to address discrepancies and improve processes.
2026-03-12T00:00:00Z

Medical Billing Specialist

Raeford, NC
onsite
Temporary
15 - 17 USD / Hourly
We are looking for a skilled Medical Billing Specialist to join our team in Fayetteville, North Carolina. In this long-term contract position, you will play a vital role in ensuring accurate billing procedures and supporting the financial operations of a local healthcare facility. This opportunity is ideal for individuals with a strong background in medical billing who are committed to maintaining high standards of professionalism and efficiency. Responsibilities:• Process medical billing claims accurately and efficiently to ensure timely reimbursement.• Review and verify essential patient information and insurance details before submitting claims.• Investigate and resolve billing discrepancies to ensure smooth operations.• Collaborate with healthcare staff to clarify billing issues and improve processes.• Maintain up-to-date knowledge of billing codes, insurance policies, and regulations.• Generate detailed billing reports to track revenue and identify trends.• Communicate effectively with insurance companies to address denied claims or appeals.• Ensure confidentiality and security of patient billing records.• Assist in optimizing billing workflows to enhance overall productivity.
2026-02-13T00:00:00Z

Medical Billing Specialist

Loveland, CO
onsite
Temporary
22.8 - 24 USD / Hourly
We are looking for a skilled Medical Billing Specialist to join our healthcare team in Loveland, Colorado. In this contract role, you will contribute to the accuracy and efficiency of medical billing operations, ensuring compliance with industry standards and supporting patient care. This position is ideal for professionals with expertise in medical billing systems, a keen eye for detail, and a commitment to delivering exceptional service. Responsibilities: • Process and submit insurance claims with precision, adhering to regulatory guidelines. • Monitor accounts receivable, address discrepancies, and ensure timely resolution of outstanding balances. • Utilize medical billing software, including Allscripts and Cerner Technologies, to manage billing tasks effectively. • Follow up on denied claims, manage appeals, and secure payments from insurance providers. • Perform medical coding and ensure documentation aligns with established industry standards. • Oversee third-party billing and maintain communication with insurance companies for seamless operations. • Verify patient benefits and eligibility while assisting with related administrative tasks. • Enter numeric data accurately and maintain detailed records of billing transactions. • Respond to inquiries from patients and healthcare providers, delivering excellent customer service. • Collaborate with colleagues to streamline billing processes and enhance workflow efficiency.
2026-03-13T00:00:00Z

Medical Billing Specialist

Syracuse, NY
onsite
Temporary
20 - 25 USD / Hourly
Position Description:This Billing Specialist is an experienced support role with expertise in Home Health Care billing processes, including PDGM, episodic, and institutional claims. The Billing Specialist will have work tasks and responsibilities with accounts receivable (AR) and revenue cycle management, combined with advanced knowledge of electronic billing and claims management systems. This role requires exceptional attention to detail, analytical problem-solving skills, and the ability to ensure accurate and timely claims submission and payment processing. Performance Responsibilities and Standards:1. Review and analyze claims for accuracy and completeness, obtain and/or correct any missing or inaccurate information related to Home Health Care (PDGM, Episodic, Institutional Claims) 2. Compile and submit claims/invoices to appropriate payors/clients within the timeframe designated within the department billing schedule. 3. Must have prior experience in AR/Revenue cycle to ensure timely follow up on claims/invoices. 4. Research and work/appeal unpaid claims when appropriate to ensure optimum collections. 5. Post payments timely with 100% accuracy. 6. Knowledge of electronic billing, billing exceptions and EDI software (Waystar) to ensure claims are submitted and followed up timely. 7. Communicate billing, payment and collections issues to Billing Manager on a current basis. 8. Utilize agency IT systems to carry out job requirements. 9. Attend meetings and workshops as required. 10. Required to bill and collect within the payor filing requirements. 11. All other duties as assigned
2026-03-04T00:00:00Z

Medical Billing Specialist

Nashville, TN
onsite
Temporary
18.2115 - 21.087 USD / Hourly
We are looking for a detail-oriented Medical Billing Specialist to join our team on a long-term contract basis. In this role, you will play a crucial part in ensuring accurate billing processes, verifying insurance coverage, and supporting financial counselors in assessing patient financial responsibilities. This position is based in Nashville, Tennessee, and offers an opportunity to contribute to the healthcare industry. Responsibilities: • Confirm patient eligibility and collaborate closely with the front desk and authorization team to ensure billing accuracy. • Distinguish between various insurance contracts and payer systems, including Medicare, Medicaid, and private insurance. • Communicate effectively with insurance companies to determine coverage details and resolve discrepancies. • Verify patient insurance information and relay necessary data to Patient Financial Counselors for financial responsibility assessments. • Utilize tools such as Availity to process claims efficiently and maintain organized records. • Handle medical claims, coding, and collections with precision to support revenue cycle processes. • Ensure accurate processing of copays and deductions to minimize errors. • Stay updated on healthcare billing regulations and compliance requirements. • Provide support in resolving billing issues and addressing patient inquiries. • Collaborate with team members to improve workflows and optimize billing practices.
2026-03-11T00:00:00Z

Medical Billing Specialist

Encino, CA
onsite
Temporary
23.75 - 30.23 USD / Hourly
A Behavioral Healthcare Company is looking for an experienced Medical Billing Specialist with ABA experience to join its Revenue Cycle Team. The Medical Billing Specialist will play a vital role in managing the revenue cycle by ensuring accurate billing, payment processing, and authorizations. This Medical Billing Specialist requires someone with strong attention to detail who can navigate insurance claims, resolve discrepancies, assist patients with EOB explanation and maintain compliance with healthcare regulations. Responsibilities:• Prepare and submit medical claims to insurance companies, including commercial payers and private, ensuring accuracy and compliance.• Monitor and track the status of submitted claims to ensure timely reimbursement.• Post payments from insurance companies and patients with precision and accuracy.• Manage patient account balances, including collections and establishing payment plans when necessary.• Investigate and address claim denials, rejections, and underpayments, identifying solutions to secure proper reimbursement.• Draft and submit appeals with supporting documentation to resolve complex claim issues.• Communicate effectively with insurance carriers and patients to address billing inquiries and concerns.• Maintain detailed and accurate records of billing activities and ensure compliance with payer guidelines.• Support the organization’s financial health by optimizing the revenue cycle processes.• ABA and/or Mental/Behavioral Health is a PLUS! This company offer Medical, Dental and Vision Insurance. 401K Retirement Plan, Sick Time Off and Tuition reimbursement.
2026-03-11T00:00:00Z

Medical Billing Specialist

La Puente, CA
onsite
Contract / Temporary to Hire
23.75 - 28.23 USD / Hourly
A Larger Medical Center in the La Puente Area is in the need of a d Medical Billing Specialist with strong Medi-Cal insurance experience. The Medical Billing Specialist will play a key part in managing the revenue cycle and ensuring accurate billing for Medi-Cal programs. The Medical Billing Specialist must have expertise to maintain compliance with provider guidelines and optimize reimbursement processes. Experience in OBGYN and/or Perinatal Services is a bit plus. Responsibilities:• Verify patient eligibility for Medi-Cal and confirm Managed Care Plan assignments for services rendered.• Prepare and submit claims accurately using appropriate coding and modifiers, including electronic equivalents of CMS-1500 forms.• Post payments, reconcile accounts, and ensure adjustments and write-offs align with contractual requirements.• Analyze denied or underpaid claims, identify issues, and resubmit them to secure proper reimbursement.• Manage appeals by reviewing Explanation of Benefits and engaging with the appeals process to resolve claim discrepancies.• Maintain secure and compliant records of Protected Health Information used in billing activities.• Assist healthcare providers with billing inquiries and support case management practices to enhance revenue.• Ensure all billing activities align with Medi-Cal Provider Manual and Managed Care Plan guidelines.• Collaborate with internal teams to streamline billing processes and improve efficiency.
2026-03-12T00:00:00Z

Medical Billing Specialist

Glen Burnie, MD
onsite
Contract / Temporary to Hire
20.24 - 23.51 USD / Hourly
We are looking for a dedicated Medical Billing Specialist. In this Contract to permanent position, you will play a vital role in ensuring accurate and efficient processing of medical claims, helping the organization maintain compliance and achieve timely reimbursements. This role requires a keen eye for detail and a strong understanding of medical billing processes and terminology. Responsibilities:• Prepare and submit accurate medical claims to insurance providers for reimbursement.• Verify patient information, including demographics and insurance details, to ensure claims are processed correctly.• Review denied or unpaid claims, identify issues, and submit appeals to resolve discrepancies.• Communicate effectively with insurance companies, patients, attorneys, and healthcare providers to address billing inquiries.• Maintain compliance with patient confidentiality regulations and organizational standards.• Monitor and manage accounts receivable, ensuring timely follow-up on outstanding balances.• Collaborate with team members to improve billing procedures and enhance operational efficiency.• Maintain accurate records of billing activities and updates within electronic medical systems.
2026-03-13T00:00:00Z

Credit & Collections Specialist

Conshohocken, PA
onsite
Permanent
55000 - 65000 USD / Yearly
Robert Half has partnered with a thriving manufacturing company on their search for an experienced Credit & Collections Specialist. The responsibilities for this role will consist of: evaluating credit applications, monitoring customer credit limits, collecting outstanding payments, resolving billing issues, assisting with charge backs, updating credit profiles, collaborating with sales and management on credit decisions and terms, analyze customer accounts, recommending accounts for third-party collections, arranging debt payoffs, and ensuring compliance with policies and applicable credit/collections laws and regulations. Ultimately, this Credit & Collections Specialist will process payments and refunds, update account records, and provide assistance where collection efforts are needed. Primary Duties· Create and maintain credit history records· Set up new client accounts· Document daily collection activity· Complete collection effort calls· Reviewing and approving credit holds· Generate legal collections documents· Spreadsheet Maintenance· Perform payment reconciliations· Assist customer service department· Develop and schedule payment plans
2026-02-24T00:00:00Z

Medical Denials Specialist

Carmel, IN
onsite
Temporary
18 - 22 USD / Hourly
Join our dynamic healthcare team as a Medical Denials Specialist and play a key role in resolving denied medical claims efficiently and accurately. Schedule: Monday–Friday, 8:00 am – 5:00 pm Key Responsibilities:<ul><li>Review insurance denial notifications and conduct thorough research to resolve outstanding claims issues.</li><li>Analyze denial patterns and root causes, recommending process enhancements to prevent future occurrences.</li><li>Communicate directly with insurance payers to troubleshoot and expedite claim resolutions.</li><li>Prepare, document, and submit appeals for denied claims.</li><li>Work closely with billing teams, healthcare providers, and insurance companies to ensure smooth claims management.</li><li>Stay informed on payer guidelines and current healthcare compliance regulations.</li><li>Consistently maintain adherence to HIPAA requirements and internal policies.</li></ul>
2026-03-04T00:00:00Z

Credentials Coordinator

Los Angeles, CA
onsite
Temporary
30.7 - 34.62 USD / Hourly
Our client is looking for a Credentialing Coordinator! The Credentialing Coordinator performs core functions within the credentialing lifecycle, including provider onboarding, credential verification, and maintenance of credentialing records. The Credentialing Coordinator role supports the medical staff services department by ensuring accurate and timely processing of credentialing documentation while maintaining compliance with regulatory standards and organizational policies. Job Requirements: <ul><li>Manage credentialing lifecycle processes including initial appointments, reappointments, privileging, and focused professional practice evaluations (FPPE)/proctoring.</li><li>Collect required documentation and conduct primary source verification to ensure provider credential files are complete and compliant.</li><li>Maintain accurate, organized, and error-free credentialing files, ensuring timely processing and updates.</li><li>Support provider onboarding by coordinating computer access, training, orientation, and ID badging.</li><li>Maintain working knowledge of medical staff bylaws, rules, regulations, and regulatory agency requirements.</li><li>Assist with the maintenance and accuracy of the medical staff credentialing database.</li><li>Ensure strict confidentiality regarding all medical staff and credentialing information.</li><li>Perform additional duties as assigned.</li></ul>
2026-03-11T00:00:00Z