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9 results for Credentialing Specialist in Costa Mesa, CA

Credentialing Specialist

Long Beach, California
onsite
Temporary / Contract
26 - 28 USD / Hourly
A healthcare company is looking for an experienced Credentialing Specialist to lead credentialing and provider data activities for a healthcare organization in Long Beach, California. The Credentialing Specialist is responsible for managing provider onboarding, recredentialing, payer enrollment support, and provider record maintenance while ensuring compliance with regulatory, accreditation, and health plan requirements. The Credentialing Specialist will also collaborate with internal teams to improve workflows, maintain audit readiness, and promote accurate, consistent credentialing practices. Key Responsibilities:<ul><li>Manage day-to-day credentialing activities for providers, including initial appointments, reappointments, and related follow-up tasks.</li><li>Coordinate provider onboarding, recredentialing cycles, payer enrollment support, and privileging documentation to ensure timely processing.</li><li>Maintain compliance with accreditation standards, delegated credentialing requirements, and applicable state and federal regulations.</li><li>Review credentialing files, provider rosters, and supporting documentation for completeness, accuracy, and timely updates.</li><li>Monitor credentialing volume, track turnaround times, and help resolve issues that may delay provider processing.</li><li>Conduct routine audits of credentialing records and assist with preparation for internal and external audits or delegated reviews.</li><li>Partner with leadership and cross-functional teams to support process improvements, policy updates, and reporting needs.</li><li>Maintain provider data integrity across systems to support accurate reporting, downstream operations, and compliance requirements.</li></ul>Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-09-17T00:00:00Z

Credentialing Specialist

Long Beach, California
onsite
Temporary / Contract
24 - 28 USD / Hourly
A healthcare organization in Long Beach, California is seeking an experienced Credentialing Specialist to support core credentialing and provider data operations. This role is responsible for managing provider onboarding, recredentialing, payer enrollment support, and provider record maintenance while ensuring compliance with regulatory, accreditation, and health plan requirements. The Credentialing Specialist will also collaborate with internal teams to improve workflows, maintain audit readiness, and promote accurate, consistent credentialing practices. Key Responsibilities:<ul><li>Manage day-to-day credentialing activities for providers, including initial appointments, reappointments, and related follow-up tasks.</li><li>Coordinate provider onboarding, recredentialing cycles, payer enrollment support, and privileging documentation to ensure timely processing.</li><li>Maintain compliance with accreditation standards, delegated credentialing requirements, and applicable state and federal regulations.</li><li>Review credentialing files, provider rosters, and supporting documentation for completeness, accuracy, and timely updates.</li><li>Monitor credentialing volume, track turnaround times, and help resolve issues that may delay provider processing.</li><li>Conduct routine audits of credentialing records and assist with preparation for internal and external audits or delegated reviews.</li><li>Partner with leadership and cross-functional teams to support process improvements, policy updates, and reporting needs.</li><li>Maintain provider data integrity across systems to support accurate reporting, downstream operations, and compliance requirements.</li></ul>Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-09-14T00:00:00Z

Medical Authorizations Specialist

Los Angeles, California
onsite
Temporary / Contract
24.07 - 30.12 USD / Hourly
A Hospital in Los Angeles is looking for an experienced Medical Authorizations Specialist to support patient access and revenue cycle operations for a healthcare organization. The Medical Authorizations Specialist position focuses on securing timely insurance approvals, insurance verifications confirming coverage details, and helping patients move forward with needed services without unnecessary delays. The Medical Authorizations Specialist candidate brings strong payer knowledge, sound judgment, and a patient-centered approach in a fast-moving hospital or clinical environment. Responsibilities:• Manage authorization and precertification requests for scheduled and unscheduled services across a range of government and commercial health plans.• Confirm active medical insurance coverage, benefit levels, and service-specific requirements before care is delivered to reduce claim and scheduling issues.• Evaluate provider orders and supporting clinical records to prepare complete submissions that align with payer criteria.• Track open requests, communicate with insurers, and take timely action to obtain determinations within required turnaround times.• Share updates on approval, denial, or pending status with care teams, schedulers, physicians, and patients as needed.• Investigate barriers that could interrupt treatment timelines and work with internal and external parties to resolve them quickly.• Record authorization activity, follow-up efforts, and outcomes accurately within the electronic medical record and related billing systems.• Assist with reconsiderations or appeals when requests are postponed or denied, using documentation that supports medical necessity.• Stay informed on changing payer rules, regulatory expectations, and authorization workflows while protecting patient confidentiality at all times.
2026-09-21T00:00:00Z

Credit Specialist

Brea, California
onsite
Temporary to Hire
26 - 27 USD / Hourly
We are looking for a Credit Specialist to join an electronic components manufacturing organization in Brea, California. This contract opportunity with permanent potential is ideal for someone who thrives in a fast-paced finance environment and can confidently manage account reconciliations, payment issues, and deduction research. The person in this role will help maintain accurate customer account balances, support healthy cash flow, and collaborate with internal partners to resolve billing-related concerns. Responsibilities:• Reconcile assigned customer accounts by reviewing chargebacks, short payments, and other account discrepancies to ensure records remain accurate.• Investigate overdue invoices and follow up with customers to secure payment or determine the cause of delayed remittance.• Analyze customer deductions, validate supporting documentation, and work toward timely resolution of disputed items.• Review account standing and release orders for shipment when credit conditions and payment status support approval.• Prepare recurring updates for leadership that highlight collection activity, aging trends, cash expectations, and past-due balances.• Partner with teams across sales, sales support, and accounting to address billing questions and resolve account-related issues efficiently.• Provide guidance to colleagues within the credit function when training support is needed or assigned by management.• Offer backup assistance for select supervisory tasks when department leadership is unavailable.• Contribute to additional credit and collections activities as needed to support departmental priorities and service levels.
2026-09-10T00:00:00Z

Medical Billing Specialist

Encino, California
onsite
Temporary to Hire
24.91 - 30.12 USD / Hourly
We are looking for an experienced Medical Billing Specialist to join a healthcare organization in California. This Medical Billing Specialist opportunity is ideal for someone with a strong background in surgical and ambulatory facility billing who can support accurate claim processing and healthy revenue cycle performance. The Medical Billing Specialist will work closely with payers, patients, and internal teams to resolve billing issues, improve reimbursement outcomes, and maintain compliant account documentation. Responsibilities:• Prepare and submit facility claims for surgical services with careful attention to completeness, accuracy, and payer-specific rules.• Review procedure details, patient information, coverage data, and required authorizations before releasing claims for billing.• Apply appropriate coding elements, including diagnosis and procedure codes, modifiers, and revenue details, to support proper reimbursement.• Enter and reconcile insurance payments, patient payments, adjustments, and other account activity in a timely manner.• Analyze remittance documents and explanation of benefits statements to identify denials, short payments, and billing variances.• Pursue outstanding receivables by contacting payers, researching account status, and escalating issues affecting reimbursement.• Investigate rejected claims and denial trends, then prepare corrected submissions, reconsiderations, or appeals when needed.• Monitor aging reports and organize follow-up efforts based on deadlines, claim value, and collection priorities.• Communicate with insurance representatives, physician offices, patients, and internal departments to address account questions and resolve discrepancies.• Maintain complete billing records while following healthcare privacy standards and current reimbursement regulations.
2026-09-23T00:00:00Z

Medical Biller/Collections Specialist

Los Angeles, California
onsite
Temporary to Hire
25.13 - 30.8 USD / Hourly
We are looking for an experienced Medical Biller/Collections Specialist to support a busy revenue cycle team in Los Angeles. This Medical Biller/Collections Specialist position is ideal for someone who understands the full medical billing lifecycle and can drive timely reimbursement across commercial, government, and patient accounts. The Medical Biller/Collections Specialist in this role will help strengthen accounts receivable performance by resolving claim issues, pursuing outstanding balances, and maintaining accurate billing documentation. Responsibilities:• Prepare and transmit clean claims to insurance carriers and government programs in a timely manner to support consistent cash flow.• Review outstanding accounts and take proactive steps to collect payment on unpaid, denied, or partially reimbursed claims.• Analyze accounts receivable aging and prioritize follow-up activities to reduce open balances and improve resolution times.• Research claim edits, rejections, and denials, then complete corrections, resubmissions, or appeals as appropriate.• Enter payments, contractual adjustments, and denial information accurately within the billing records.• Communicate with health plans, patients, and internal team members to clarify billing questions and move accounts toward resolution.• Ensure billing activity aligns with payer rules, regulatory standards, and established organizational procedures.• Assist with broader revenue cycle tasks such as claim review, payment balancing, account investigation, and detailed documentation of collection efforts.
2026-09-22T00:00:00Z

Medical Biller/Collections Specialist

Los Angeles, California
onsite
Temporary to Hire
26.6 - 30.8 USD / Hourly
An Ambulatory Surgery Center in Los Angeles is in the need of a Medical Biller/Collections Specialist. This Medical Biller/Collections Specialist is ideal for someone who understands the full revenue cycle and can confidently manage claims, denials, and payer follow-up for surgical services. The right candidate for the Medical Biller/Collections Specialist role will bring healthcare billing experience, strong insurance knowledge, and the ability to keep accounts moving toward timely reimbursement. Responsibilities:• Manage end-to-end billing and collections activities for surgical services, from charge review through payment follow-up.• Confirm patient coverage, authorization details, and payer information using available electronic records and insurance carrier resources before claims are submitted.• Enter billing data and post charges accurately for surgical cases while maintaining complete and organized account documentation.• Pursue outstanding third-party balances by conducting regular follow-up with commercial and government payers across multiple plan types.• Investigate explanation of benefits, identify denial causes, correct claim issues, and resubmit claims to support reimbursement.• Monitor assigned claim queues and worklists each day to address unresolved accounts, aging items, and billing exceptions in a timely manner.• Review provider documentation, including urgent care and surgical records, to ensure charges are supported and billing can proceed accurately.• Apply appropriate diagnosis, procedure, medication, and supply codes based on clinical documentation and operative reports completed by providers.• Examine aged accounts and unresolved payer responses to resolve denials, appeals, and collection issues efficiently.
2026-09-16T00:00:00Z

Benefits Specialist

Irvine, California
onsite
Temporary to Hire
34.257 - 39.666 USD / Hourly
We are looking for a Benefits Specialist to join a team in Irvine, California in a Contract to Permanent role. This position supports the delivery of employee benefits programs by helping with enrollments, employee inquiries, records management, and benefits system activity. The ideal candidate brings strong attention to detail, a service-oriented approach, and the ability to manage several priorities while contributing to a positive employee experience. Responsibilities: • Provide day-to-day support for health, retirement, life, disability, and voluntary benefit programs while ensuring employees receive accurate and timely assistance. • Investigate and resolve issues related to enrollments, eligibility, carrier connections, billing questions, and claims concerns. • Guide employees through benefits processes and help them use benefits administration tools effectively. • Process benefits-related events such as employee enrollments, life status changes, and open enrollment activities while monitoring deadlines and documentation requirements. • Partner with HR teams and internal stakeholders to verify data accuracy, reconcile records, and address discrepancies with carriers or system files. • Assist with audits, testing, troubleshooting, and ongoing maintenance for HRIS and benefits administration platforms, including support for system updates or implementations when needed. • Coordinate assigned benefits projects by tracking milestones, organizing communications, maintaining documentation, and following through on action items. • Contribute to process improvements, employee communications, wellness initiatives, and compliance reporting to strengthen consistency and engagement across the organization.
2026-09-18T00:00:00Z

Benefits Specialist

Brea, California
onsite
Temporary / Contract
32 - 36 USD / Hourly
We are looking for someone with 2–4 years of hands-on employee benefits and/or HR experience who can jump in and support the Benefits Manager across a portfolio of approximately 23 brands.The ideal candidate will have experience with:• Medical, dental, vision, life, disability, 401(k), and voluntary benefits • New hire enrollment and qualifying life events • Open enrollment and benefits administration • Employee questions and benefits issue resolution • Eligibility, carrier, billing, claims, and enrollment discrepancies • HRIS and/or benefits administration systems • Benefits reporting, audits, and data reconciliation • Basic ACA compliance knowledge • Excel and Microsoft Office • Managing multiple projects, deadlines, and follow-ups • Working with HR, payroll, carriers, vendors, and employees
2026-09-18T00:00:00Z