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7 results for Credentialing Specialist in Laguna Niguel, CA

Credentialing Specialist

Long Beach, CA
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, CA
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

Credit Specialist

Brea, CA
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

Enrollment Specialist

Huntington Beach, CA
onsite
Temporary / Contract
19.7885 - 22.913 USD / Hourly
We are looking for an Enrollment Specialist to support individuals exploring federal student loan repayment and forgiveness solutions in Huntington Beach, California. This Contract position is ideal for someone who combines strong customer service instincts with the ability to explain complex program information in a clear and supportive way. The role focuses on helping prospective clients understand their options, complete enrollment steps accurately, and move through the process with confidence. Responsibilities: • Speak with prospective clients to understand their student loan situations and provide informed guidance on available federal repayment and forgiveness pathways. • Evaluate borrower financial details, loan information, and other relevant documentation to identify programs that may match eligibility criteria. • Walk clients through each phase of enrollment, including gathering required paperwork and ensuring forms are prepared correctly and completely. • Record client conversations, application updates, and enrollment progress accurately within company systems to maintain organized case files. • Handle sensitive personal and financial information in accordance with established policies, regulatory expectations, and confidentiality standards. • Provide attentive, compassionate service that helps clients feel informed, supported, and confident in their decisions. • Work closely with colleagues across teams to coordinate documentation flow and promote timely completion of enrollment activities. • Balance productivity goals with quality standards by maintaining accurate work, responsive communication, and a consultative client experience.
2026-09-18T00:00:00Z

Medical Biller/Collections Specialist

Los Angeles, CA
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, CA
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, CA
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