<p>The Credentialing Specialist is responsible for supporting the credentialing, re‑credentialing, and provider enrollment processes to ensure healthcare professionals meet all regulatory, payer, and organizational requirements. This role plays a key part in maintaining compliance, supporting provider onboarding, and ensuring accurate and up‑to‑date credentialing records. The Credentialing Specialist works closely with internal teams, providers, and external agencies to collect, verify, and track required documentation.</p><ul><li>Coordinate and manage initial credentialing and re‑credentialing for healthcare providers</li><li>Collect, review, and maintain provider documentation (licenses, certifications, education, work history, malpractice coverage, etc.)</li><li>Perform primary source verification in accordance with regulatory and organizational standards</li><li>Track license, certification, and enrollment expiration dates to ensure ongoing compliance</li><li>Maintain accurate provider records within credentialing databases and internal systems</li><li>Communicate with providers and internal stakeholders regarding application status and missing documentation</li><li>Assist with payer enrollment and revalidation processes, as assigned</li><li>Support audits and ensure credentialing files are complete and compliant</li><li>Maintain confidentiality and comply with HIPAA and regulatory requirements</li><li>Perform additional administrative or credentialing support duties as needed</li></ul><p><strong>Benefits:</strong> Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.</p>
<p>We are looking for a detail-oriented Medical Records Technician to join our team in Santa Ana, California. In this long-term contract position, you will play a key role in retrieving and managing medical records to support healthcare operations. This opportunity offers a dynamic mix of fieldwork and independent tasks, perfect for someone who thrives in a flexible and fast-paced environment.</p><p><br></p><p>Responsibilities:</p><p>• Travel to healthcare facilities within a 40-mile radius to retrieve medical records, both in paper and electronic formats.</p><p>• Upload medical charts into a secure system using company-provided equipment, ensuring data accuracy and confidentiality.</p><p>• Manage daily tasks independently, with the flexibility to complete submissions from home after fieldwork is done.</p><p>• Participate in two days of remote, paid training to gain the necessary skills for risk adjustment processes.</p><p>• Utilize company-provided tools, including a password-protected laptop, scanner, and flash drives, to perform tasks efficiently.</p><p>• Collaborate with team members and leaders to ensure smooth chart retrieval operations.</p><p>• Maintain accurate documentation and reporting of records retrieved during field visits.</p><p>• Provide excellent customer service while interacting with healthcare providers and office staff during chart retrieval.</p><p>• Follow all data security protocols to protect sensitive medical information.</p>
<p>Join our team as an OBGYN Medical Biller and play a key role in supporting women’s health clinics. We are looking for an experienced medical billing professional who understands the complexities of OBGYN coding and has proven expertise in Medi-Cal insurance and reimbursement processes.</p><p>Responsibilities:</p><ul><li>Accurately enter and process medical bills for OBGYN visits, procedures, and ancillary services</li><li>Review and validate ICD-10, CPT, and HCPCS codes specific to OBGYN care</li><li>Ensure compliance with Medi-Cal guidelines and regulations for claims submission</li><li>Track, follow up, and resolve denials and rejections for Medi-Cal claims</li><li>Maintain clear communication with providers, payers, and patients regarding billing issues</li><li>Collaborate with clinical and administrative staff to ensure proper documentation</li><li>Generate and review monthly billing reports for accuracy and completeness</li></ul><p><br></p>
<p>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.</p><p><br></p><p>Responsibilities:</p><p>• Verify patient eligibility for Medi-Cal and confirm Managed Care Plan assignments for services rendered.</p><p>• Prepare and submit claims accurately using appropriate coding and modifiers, including electronic equivalents of CMS-1500 forms.</p><p>• Post payments, reconcile accounts, and ensure adjustments and write-offs align with contractual requirements.</p><p>• Analyze denied or underpaid claims, identify issues, and resubmit them to secure proper reimbursement.</p><p>• Manage appeals by reviewing Explanation of Benefits and engaging with the appeals process to resolve claim discrepancies.</p><p>• Maintain secure and compliant records of Protected Health Information used in billing activities.</p><p>• Assist healthcare providers with billing inquiries and support case management practices to enhance revenue.</p><p>• Ensure all billing activities align with Medi-Cal Provider Manual and Managed Care Plan guidelines.</p><p>• Collaborate with internal teams to streamline billing processes and improve efficiency.</p>
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. <br> 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. <br> 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.
<p>A leading Healthcare Sub-Acute Care Center is seeking a diligent and highly organized Medical Administrative Assistant to support our growing team. In this vital role, the Medical Administrative Assistant will ensure the seamless operation of our office environment, with a primary focus on healthcare administration. Candidates with a proven track record in managing administrative operations in healthcare settings are encouraged to apply. This role can lead to exciting opportunities in healthcare administration.</p><p><br></p><p><strong>Key Responsibilities:</strong></p><ul><li>Oversee daily administrative functions to facilitate efficient facility operations.</li><li>Coordinate with patients, healthcare providers, and insurance companies to obtain treatment authorizations.</li><li>Verify insurance coverage, including benefit validation and eligibility checks, and perform accurate patient data entry.</li><li>Process referrals, pre-authorizations, and pre-certifications for all patient cases.</li><li>Act as the first point of contact, answering phones, scheduling appointments, filing paperwork, and assisting patients and staff with inquiries.</li><li>Communicate professionally and courteously with patients, families, physicians, facility staff, and external partners.</li><li>Maintain strict compliance with HIPAA and patient confidentiality standards.</li><li>Support other general administrative tasks and adapt to rapidly changing priorities.</li></ul><p><strong>Benefits: </strong>Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.</p>