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8 results for Credentialing Specialist in Cerritos, CA

Credentialing Specialist

Santa Monica, CA
onsite
Temporary / Contract
32 - 45 USD / Hourly
We are looking for a Credentialing Specialist to support credentialing and privileging activities for physician staff in Santa Monica, California. This Credentialing Specialist plays an important role in maintaining accurate provider records, supporting compliance efforts, and coordinating documentation for appointment and reappointment workflows. The ideal candidate brings prior experience in a hospital or healthcare environment, strong working knowledge of MD Staff, and the ability to manage sensitive information with accuracy and care. Key Responsibilities:<ul><li>Oversee the end‑to‑end credentialing cycle for physicians within an MSO‑supported, multi‑site environment, including new appointments, renewals, and ongoing provider status maintenance.</li><li>Review and validate provider documentation such as licenses, education, certifications, employment history, references, and malpractice coverage, ensuring alignment with MSO, payer, and organizational standards.</li><li>Administer privilege requests and updates by tracking clinical privileges across affiliated practices and service locations, ensuring consistency with governing bylaws, MSO policies, and medical staff requirements.</li><li>Maintain complete, accurate, and current practitioner files within the MD Staff platform, supporting MSO credentialing operations, data integrity, and audit readiness.</li><li>Track expiring credentials and proactively follow up to obtain renewed licenses, certifications, and supporting documentation needed for MSO participation and payer enrollment continuity.</li><li>Assemble credentialing and re‑credentialing packets for review by medical staff committees, leadership groups, and MSO governance bodies.</li><li>Support compliance with Joint Commission, NCQA, CMS, and MSO‑specific accreditation and regulatory standards.</li><li>Serve as a primary point of contact for physicians, department leaders, MSO stakeholders, and affiliated practices regarding application status, missing items, and approval timelines.</li><li>Contribute to audits, survey preparation, policy updates, and process improvement initiatives related to MSO credentialing, provider enrollment, and medical staff services.</li></ul> Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-04-25T00:00:00Z

Medical Credentialing Administrative Assistant

Santa Monica, CA
onsite
Temporary / Contract
26 - 37 USD / Hourly
We are looking for a detail-oriented Medical Administrative Assistant to support the Medical Staff department in Santa Monica, California. This Medical Administrative Assistant position is ideal for someone who excels at coordinating administrative processes, maintaining accurate records, and keeping compliance-related documentation current in a busy healthcare setting. The role also involves organizing department meetings, preparing documentation, and communicating effectively with physicians, staff, and leadership. Success in this position requires sound judgment, strong organizational skills, and the ability to handle confidential information with care. Key Responsibilities:• Oversee the tracking of time‑sensitive items such as licenses, certifications, privileging documents, and other required medical staff records to support ongoing compliance.• Maintain accurate, complete, and current credentialing and departmental records across internal files and systems.• Arrange department and committee meetings by managing calendars, confirming attendance, preparing agendas, and assembling supporting materials.• Record clear, thorough meeting minutes, track action items, and distribute finalized documentation promptly to physicians, leadership, and other stakeholders.• Perform document control, filing, and data entry tasks to ensure information is organized, accessible, and audit‑ready.• Follow up with physicians, team members, and leadership regarding outstanding paperwork, renewals, and submission deadlines.• Provide day‑to‑day administrative support for the Medical Staff department, including office coordination, communication support, and confidential information handling. Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-04-25T00:00:00Z

Medical Enrollment Specialist

Buena Park, CA
onsite
Temporary / Contract
21 - 28 USD / Hourly
Our healthcare team is seeking a detail-oriented Medical Insurance Enrollment Specialist with at least two years of experience and fluency in Spanish and English. The ideal candidate is passionate about helping patients navigate insurance processes and enjoys a fast-paced, supportive environment.Responsibilities:<ul><li>Process and review medical insurance enrollments for new and existing patients</li><li>Verify insurance coverage, eligibility, and benefits with various payers</li><li>Collaborate with patients, providers, and insurers to resolve enrollment questions and discrepancies</li><li>Maintain accurate and timely data entry in healthcare management systems</li><li>Communicate benefits information and enrollment outcomes to patients in both Spanish and English</li><li>Ensure compliance with HIPAA and company privacy policies</li><li>Provide exceptional customer service while assisting patients with insurance inquiries</li></ul>Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-04-24T00:00:00Z

Enrollment Specialist

Buena Park, CA
onsite
Temporary to Hire
24 - 29 USD / Hourly
We are looking for a dedicated Enrollment Specialist to join our team in Buena Park, California. The Enrollment Specialist will play a vital role in assisting patients with their health insurance enrollment through programs like Covered California and Medi-Cal. This is an excellent opportunity for someone passionate about helping individuals navigate the complexities of healthcare coverage. Key Responsibilities:• Assist patients in completing applications and verifying their eligibility for health insurance programs, including Covered California and Medi-Cal.• Provide clear explanations of insurance options, benefits, and coverage to help patients make informed decisions.• Ensure all enrollment records are accurate by verifying documentation and resolving discrepancies.• Maintain up-to-date records of enrollment activity and manage data entry into internal systems.• Conduct follow-ups with patients to finalize incomplete applications or handle renewal processes.• Collaborate with community outreach teams to support enrollment initiatives and drive awareness.• Deliver excellent customer service by addressing patient inquiries and concerns promptly.• Stay informed about changes in health insurance policies to provide accurate guidance to patients. Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-04-24T00:00:00Z

Medical Billing Specialist

Van Nuys, CA
onsite
Temporary to Hire
25.3365 - 29.337 USD / Hourly
We are looking for a skilled Medical Billing Specialist to join our team in Los Angeles, California. This Contract to permanent position offers an exciting opportunity to manage comprehensive billing operations for a multi-specialty healthcare practice, with a focus on Ear, Nose, and Throat services. The ideal candidate will have expertise in claim submission, collections, and patient communications, as well as experience with out-of-network and concierge billing models. Responsibilities: • Manage the full cycle of medical billing processes, including claim submissions, payer follow-ups, payment resolutions, and collections. • Review and ensure the accuracy of coding and charges for services provided by multi-specialty healthcare providers. • Conduct quality assurance checks and audits of billing tasks performed by team members. • Handle out-of-network billing and provide support for concierge-model practices. • Investigate and resolve unpaid, denied, or underpaid claims to minimize accounts receivable backlog. • Assist with collections and reimbursement strategies to optimize revenue. • Maintain detailed and accurate billing records, including comprehensive account documentation. • Ensure compliance with payer policies, industry standards, and internal workflows. • Utilize systems such as Kareo/Tebra and eClinicalWorks effectively to streamline billing operations.
2026-04-24T00:00:00Z

Medical AR Insurance Specialist

Los Angeles, CA
onsite
Temporary / Contract
23.75 - 27.5 USD / Hourly
We are looking for an experienced Medical AR Insurance Specialist its team. In this role, the Medical AR Insurance Specialistwill focus on medical collections and insurance claims, ensuring accurate follow-up and resolution of outstanding balances. This is an excellent opportunity for a Medical AR Insurance Specialist to contribute your expertise in managed care and medical billing within a dynamic healthcare environment. Responsibilities:• Conduct thorough follow-ups on accounts aged 120 to 210 days to recover outstanding balances.• Investigate and resolve written-off accounts to maximize revenue recovery.• Process approximately 50-60 claims per day with attention to detail and accuracy.• Collaborate with managed care providers such as LA Care, Kaiser, and others to address billing issues.• Handle medical denials and appeals, ensuring timely and effective resolution.• Review and manage accounts associated with various insurance carriers.• Analyze and document collection efforts for reporting and compliance purposes.• Maintain up-to-date knowledge of relevant medical billing and insurance policies.• Communicate effectively with internal teams to coordinate account resolution strategies.
2026-04-21T00:00:00Z

Medical AR Insurance Specialist

Los Angeles, CA
onsite
Temporary / Contract
23.75 - 28 USD / Hourly
We are looking for an experienced Medical AR Insurance Specialist its team. In this role, the Medical AR Insurance Specialist will focus on medical collections and insurance claims, ensuring accurate follow-up and resolution of outstanding balances. This is an excellent opportunity for a Medical AR Insurance Specialist to contribute your expertise in managed care and medical billing within a dynamic healthcare environment. This role is a hybrid tole. Responsibilities:• Conduct thorough follow-ups on accounts aged 120 to 210 days to recover outstanding balances.• Investigate and resolve written-off accounts to maximize revenue recovery.• Process approximately 50-60 claims per day with attention to detail and accuracy.• Collaborate with managed care providers such as LA Care, Kaiser, and others to address billing issues.• Handle medical denials and appeals, ensuring timely and effective resolution.• Review and manage accounts associated with various insurance carriers.• Analyze and document collection efforts for reporting and compliance purposes.• Maintain up-to-date knowledge of relevant medical billing and insurance policies.• Communicate effectively with internal teams to coordinate account resolution strategies.
2026-04-21T00:00:00Z

Medical Biller/Collections Specialist

Corona, CA
onsite
Temporary / Contract
21 - 24 USD / Hourly
Are you a driven and detail-oriented detail oriented with strong experience in billing and collections? Do you enjoy learning and adapting to new systems in a dynamic work environment? We’re looking for a Medical Billing/Collections Specialist to join our team and contribute to the success of our mental health practice. This role involves working within our proprietary Windows-based billing software—a user-friendly system that’s easy to master—with training and support available every step of the way. The right candidate will bring at least 2 years of billing and collections experience, demonstrate common sense, and show a willingness to ask questions when facing challenges. You won’t need coding expertise, but you should have a clear understanding of medical billing processes. Key Responsibilities Utilize in-house proprietary billing software to manage billing and collections tasks. Process accounts with accuracy, maintaining compliance with billing procedures and organizational standards. Take initiative to master the software tools provided, ensuring correct workflows and timely account management. Address billing issues and resolve account discrepancies while adhering to ICD-10 standards (no coding experience required). Progress through a structured training program that starts with simpler accounts and builds toward more complex tasks as your understanding deepens. Communicate effectively with teammates, supervisors, and external stakeholders to achieve timely resolutions for billing inquiries. Exhibit a proactive, aggressive attitude toward learning and performing your duties at a high standard.
2026-04-15T00:00:00Z