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4 results for Credentialing Specialist in Laguna Niguel, CA

Credentialing Specialist

El Segundo, CA
onsite
Temporary / Contract
22 - 28 USD / Hourly
A healthcare company is looking for Credentialing Specialist to join a healthcare organization in El Segundo, California. This Credentialing Specialist is ideal for someone who can quickly step into a busy environment and provide hands-on support to a credentialing team managing a significant workload. The Credentialing Specialist is fully onsite and offers the chance to contribute immediately while helping maintain accurate, timely provider credentialing operations. Key Responsibilities:• Manage credentialing and recredentialing activities for physicians and other healthcare providers, ensuring files are complete, accurate, and submitted on schedule.• Review applications, supporting documents, and licensure records to verify compliance with organizational, payer, and regulatory standards.• Follow up with providers, payers, and internal teams to obtain missing information and resolve outstanding credentialing issues efficiently.• Maintain organized credentialing records and update tracking systems to reflect application status, expirations, and renewals.• Prioritize a high-volume backlog of provider files and move cases forward with strong attention to deadlines and detail.• Coordinate with department stakeholders to support daily credentialing operations and help improve workflow consistency as needs are identified. Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-21T00:00:00Z

Medical Credentialing Specialist

El Segundo, CA
onsite
Temporary / Contract
23.12 - 28 USD / Hourly
We are seeking a detail-oriented Medical Credentialing Specialist to support the credentialing and recredentialing process for healthcare providers. This role is responsible for ensuring providers meet all regulatory, accreditation, and payer requirements so they can deliver services and receive reimbursement. .Key Responsibilities:<ul><li>Manage the initial credentialing and recredentialing process for physicians, nurses, and allied health professionals. </li><li>Verify provider qualifications, including licenses, certifications, education, work history, malpractice coverage, and references. </li><li>Prepare and submit credentialing applications to hospitals, health plans, and insurance networks. </li><li>Maintain accurate provider records and ensure all documentation is current and compliant. </li><li>Track application status and follow up with payers, licensing boards, and other agencies as needed. </li><li>Monitor expiration dates for licenses, DEA registrations, board certifications, and insurance documents. </li><li>Ensure compliance with internal policies, payer standards, NCQA, CMS, and other regulatory guidelines. </li><li>Serve as a point of contact for providers and internal departments regarding credentialing status and requirements. </li><li>Assist with audits and reporting related to provider enrollment and credentialing files. .</li></ul>
2026-08-14T00:00:00Z

Credentialing Manager

Long Beach, CA
onsite
Temporary / Contract
32 - 45 USD / Hourly
A healthcare company is looking for an experienced Credentialing Manager to lead credentialing and provider data activities for a healthcare organization in Long Beach, California. This Credentialing Manager position will guide daily operations related to provider onboarding, recredentialing, enrollment support, and data accuracy while maintaining adherence to regulatory and health plan standards. The Credentialing Manager also partners with internal leaders to strengthen workflows, support audit readiness, and promote consistent credentialing practices across the function. Key Responsibilities:• Direct the day-to-day work of credentialing and provider data staff, setting priorities and providing operational guidance.• Lead provider onboarding, reappointment cycles, payer enrollment activity, and privileging coordination to keep processes moving efficiently.• Maintain compliance with applicable accreditation standards, delegated credentialing obligations, and state and federal regulations.• Review credentialing records, provider rosters, and supporting documentation to ensure information remains complete, current, and accurate.• Track team volume and turnaround times, remove workflow obstacles, and support timely resolution of credentialing issues.• Prepare the department for internal and external reviews by conducting audits and addressing gaps before formal assessments occur.• Work with leadership to refine credentialing policies, improve reporting, and enhance departmental procedures.• Oversee provider data integrity across systems and records to support reliable downstream use and regulatory reporting. Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-21T00:00:00Z

Provider Enrollment Specialist

El Segundo, CA
onsite
Temporary / Contract
23 - 28 USD / Hourly
A healthcare company is seeking Provider Enrollment Specialists to provide immediate support to a growing healthcare team managing a significant backlog. This Provider Enrollment Specialist is ideal for professionals with prior provider enrollment and healthcare credentialing experience who can step in quickly, work independently, and help improve turnaround times and overall workflow. Key Responsibilities:<ul><li>Process provider enrollment applications and related documentation for health plans, payers, and networks. </li><li>Support credentialing and recredentialing activities as needed to ensure providers are properly enrolled and maintained.</li><li>Review provider files for accuracy, completeness, and compliance with payer and regulatory requirements. </li><li>Verify licenses, certifications, education, training, and other required provider documentation. </li><li>Track application status, renewals, expirables, and follow-up items to ensure timely completion. </li><li>Communicate with providers, payers, and internal departments regarding enrollment status, missing items, and issue resolution. </li><li>Maintain accurate records and update provider information in internal databases and systems. </li><li>Assist in reducing enrollment and credentialing backlog while meeting quality and productivity expectations. </li><li>Ensure all activities are completed in accordance with organizational policies, payer guidelines, and regulatory standards.</li></ul>Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-19T00:00:00Z