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10 results for Medical Authorizations Specialist in Los Angeles, CA

Medical Credentialing Specialist

Mission Hills, CA
onsite
Temporary / Contract
32 - 45 USD / Hourly
A healthcare company is seeking an experienced Medical Credentialing Specialist to join our Medical Staff Services department. This Medical Credentialing Specialist is responsible for managing the full credentialing lifecycle for physicians and advanced practice providers, with a primary focus on initial appointments, reappointments, and clinical privileges. The Medical Credentialing Specialist is detail-oriented, highly organized, and experienced in navigating the complex regulatory requirements governing hospital credentialing. This position requires prior experience using MD-Staff software to support credentialing, privileging, and provider data management. Key Responsibilites:<ul><li>Manage the credentialing and privileging process for physicians and allied health professionals, including initial appointments, reappointments, temporary privileges, and privilege modifications, using MD-Staff to maintain accurate and current provider records.</li><li>Review applications for completeness, obtain required documentation, and perform all primary source verifications, including licensure, education, training, board certification, DEA registration, references, malpractice history, NPDB queries, and sanctions/exclusion screenings.</li><li>Prepare and maintain credentialing files, reports, and committee-ready documentation in MD-Staff for review by Department Chairs, the Credentials Committee, Medical Executive Committee (MEC), and Governing Board, while tracking expiration dates and reappointment timelines to ensure continuous compliance.</li><li>Ensure adherence to Medical Staff Bylaws, hospital policies, CMS Conditions of Participation, The Joint Commission standards, and all applicable state and federal regulations.</li><li>Partner with Human Resources, Provider Enrollment, Risk Management, department leaders, and hospital leadership to support provider onboarding, reporting, committee materials, accreditation readiness, and high-quality service to providers and stakeholders.</li></ul>Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-01T00:00:00Z

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

Medical Coder Specialist

Los Angeles, CA
remote
Temporary / Contract
35 - 39 USD / Hourly
Job Responsibilities:<ul><li>Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes leading to the assignment of the correct Medicare Severity-Diagnosis Related Group MS-DRG or All Patient Refined Diagnosis Related Group APR-DRG. The Inpatient Coding Specialist I is responsible for verification of the patient’s discharge disposition assigning the correct sources of admission for state regulation reporting purposes and ensuring the appropriate present on admission POA indicators are assigned to each code. The assigned codes must support the reason for the visit that is documented by the provider in order to support the care provided.</li><li>Correctly abstracts required data per facility specifications.</li><li>Responsible for monitoring Discharged Not Billed accounts and as a team ensures timely compliant processing of inpatient accounts through the revenue cycle.</li><li>Collaborates with Clinical Documentation Specialists CDSs and members of the medical staff to ensure completeness of documentation in the medical records so that appropriate codes and ultimately the correct Diagnosis Related Group DRG may be assigned.</li><li>Responsible for ensuring accuracy and maintaining established quality and productivity standards.</li><li>Demonstrates a high degree of independence in performance of responsibilities working effectively without direct supervision. Exhibits strong time management problem solving and communication skills.</li><li>Possesses critical thinking good judgment and decision making skills</li><li>Demonstrates excellent written and oral communication skills</li><li>Remains abreast of current Centers for Medicare and Medicaid Services CMS requirements as well as Correct Coding Initiative CCI edits Hospital Acquired Conditions HACs Patient Safety Indicators PSIs and when applicable National Coverage Determinations NCDs and Local Coverage Determinations LCDs including the addition of appropriate modifiers to ensure a clean claim the first time through.</li><li>Maintains competency and accuracy while utilizing tools of the trade such as the 3M encoder 3M Audit Expert process 3M AES 3M Clinical Documentation Improvement System 3M CDIS and abstracting systems as well as all reference materials.</li><li>Attends required system hospital and departmental meetings and educational sessions as established by leadership as well as completion of required annual learning programs to ensure continued education and growth.</li><li>Employees must abide by all Joint Commission requirements including but not limited to sensitivity to cultural diversity patient care patients rights and ethical treatment safety and security of physical environments emergency management teamwork respect for others participation in ongoing education and training communication and adherence to safety and quality programs sustaining compliance with National Patient Safety Goals and licensure and health screenings.</li></ul>
2026-07-27T00:00:00Z

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.
2026-08-14T00:00:00Z

Medical Credentialing Manager

Long Beach, CA
onsite
Temporary / Contract
36.12 - 48.01 USD / Hourly
A respected healthcare organization is seeking an experienced Credentialing Manager to lead credentialing operations and provider data management for its Long Beach, California team. In this leadership role, you'll oversee the full credentialing lifecycle—including provider onboarding, recredentialing, enrollment support, and data integrity—while ensuring compliance with regulatory requirements and health plan standards. You'll also collaborate with cross-functional leaders to optimize processes, strengthen audit readiness, and drive operational excellence across the credentialing function.Key Responsibilities:<ul><li>Lead and mentor the credentialing and provider data team, setting daily priorities and ensuring efficient operations.</li><li>Oversee provider onboarding, recredentialing, payer enrollment, and privileging activities to support a seamless provider experience.</li><li>Ensure compliance with accreditation standards, delegated credentialing requirements, and applicable state and federal regulations.</li><li>Review credentialing files, provider rosters, and supporting documentation to maintain complete, accurate, and up-to-date records.</li><li>Monitor team productivity, turnaround times, and workflow performance, proactively resolving issues that impact service levels.</li><li>Prepare for internal and external audits by conducting routine reviews, identifying gaps, and implementing corrective actions.</li><li>Partner with leadership to enhance credentialing policies, reporting capabilities, and operational workflows.</li><li>Safeguard provider data integrity across systems to support accurate reporting, compliance, and downstream operational needs.</li></ul>Benefits: Comprehensive Health, Dental, and Vision insurance, 401(k) retirement plan, and Paid Sick Time.
2026-08-05T00:00:00Z

Medical Collector

Torrance, CA
onsite
Temporary / Contract
23.01 - 27 USD / Hourly
We are seeking a detail-oriented Medical Collector to support revenue cycle operations through insurance follow-up and patient collections. This role will focus on resolving outstanding balances, contacting insurance carriers regarding claim status, denials, underpayments and payment issues, and working directly with patients to collect balances and explain account details. Key Responsibilities<ul><li>Follow up with medical insurance payers on outstanding claims, denied claims, underpayments and aged accounts receivable. </li><li>Contact patients regarding balances due and arrange payment collection in a professional and customer-focused manner. </li><li>Review explanations of benefits, remittance details and account activity to determine next steps for collection. </li><li>Investigate claim rejections, denials and payment discrepancies and take appropriate action for resolution. </li><li>Submit appeals, corrected claims or supporting documentation as needed to secure reimbursement. </li><li>Document all collection activity, payer communication and patient interactions accurately in the billing system. </li><li>Work closely with billing, payment posting and customer service teams to resolve account issues. </li><li>Maintain productivity and quality standards while managing a high-volume work queue. </li><li>Ensure collection practices comply with payer requirements, timely filing guidelines and HIPAA standards. </li></ul>Work Arrangement: On-site for the first 3 months, then hybrid based on performance and business needs.
2026-08-14T00:00:00Z

Medical Revenue Cycle Analyst

Los Angeles, CA
onsite
Temporary / Contract
37.91 - 65.23 USD / Hourly
We are seeking an experienced Revenue Cycle Analyst to join our healthcare finance team. The Revenue Cycle Analyst will be responsible for analyzing and improving revenue cycle processes, ensuring the organization's financial health while minimizing inefficiencies. The Revenue Cycle Analyst role requires strong analytical skills, healthcare billing knowledge, and the ability to collaborate across departments to optimize performance. This role is ideal for someone who possesses a Certified Coding Specialist (CCS) as this role will focus on coding denial management. Key Responsibilities:<ul><li>Perform data analysis to identify trends, issues, and opportunities for improvement within the revenue cycle processes, including billing, coding, collections, and reimbursements.</li><li>Maintain and analyze financial and operational performance metrics related to claims processing, denial management, and payment posting.</li><li>Collaborate with cross-functional teams, such as billing and collections, to streamline processes and improve revenue cycle operations.</li><li>Research industry regulations and payer policies to ensure compliance and optimize reimbursements.</li><li>Provide regular reporting to department leaders on revenue cycle performance, including key performance indicators (KPIs).</li><li>Support system upgrades and technology implementation to enhance revenue cycle efficiency.</li><li>Identify and resolve discrepancies in payments or coding to reduce denials and delays in reimbursements.</li><li>Conduct root cause analysis for claim denials and develop strategies for resolution.</li><li>Participate in budgeting and forecasting to align revenue cycle goals with financial strategies.</li></ul>
2026-08-06T00:00:00Z

Medical Staff Coordinator

Mission Hills, CA
onsite
Temporary / Contract
30 - 48 USD / Hourly
A healthcare company is looking for a Medical Staff Coordinator to support credentialing and medical staff administration for a healthcare organization in California. This Medical Staff Coordinator position focuses on overseeing provider appointments, renewals, and clinical privilege documentation while maintaining alignment with hospital standards and regulatory requirements. The Medical Staff Coordinator offers the opportunity to work closely with physicians, leadership teams, and internal departments in a fast-moving hospital environment where accuracy, organization, and service are essential. Key Responsibilities:• Oversee the full credentialing cycle for physicians and advanced practice providers, including new appointments, reappointments, and updates to clinical privileges.• Examine application materials for accuracy and completion, and follow up to obtain missing records or supporting documents.• Conduct and record primary source verification activities such as license reviews, education and training confirmation, board status checks, reference checks, malpractice history, and sanction screenings.• Track expiration dates and renewal schedules to help maintain uninterrupted credentialing status for providers.• Assemble and organize credentialing files for presentation to department leadership, credentialing committees, executive medical staff committees, and governing bodies.• Coordinate requests involving revised or newly requested clinical privileges and ensure documentation is routed appropriately.• Maintain precise provider information within credentialing systems and prepare reports, meeting materials, and survey-ready documentation for leadership review.• Work collaboratively with Human Resources, provider enrollment teams, risk management, and department leaders to support onboarding and ongoing compliance.• Uphold confidentiality standards while delivering responsive and courteous service to providers, hospital leadership, and other stakeholders. Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-14T00:00:00Z

Medical Biller Collector

Encino, CA
onsite
Temporary to Hire
24.77 - 30.8 USD / Hourly
We are looking for an experienced Medical Biller Collector to join a Surgery Center in Encino. The Medical Biller Collector is ideal for someone with a strong background in healthcare billing and insurance collections who can manage claims activity accurately and follow revenue cycle processes from submission through reimbursement. The Medical Biller Collector position supports surgical and outpatient services by ensuring charges, coding, and payer information are handled correctly and in a timely manner. Responsibilities:• Manage end-to-end billing and collections for surgical and related service charges, ensuring timely claim processing and payment resolution.• Confirm patient coverage, referral or authorization status, and payer details through electronic health record systems and insurer portals before claims are transmitted.• Enter billing information, post charges, and maintain accurate account records to support clean claim submission.• Conduct follow-up with insurance carriers on outstanding claims, denials, and unpaid balances across multiple plan types and procedures.• Review rejected or denied claims, correct billing or coding issues, and resubmit documentation to support reimbursement.• Audit provider documentation and operative reports to confirm services are fully supported before charges are released for billing.• Assign appropriate diagnosis, procedure, medication, and supply codes based on clinical documentation and established coding standards.• Evaluate explanation of benefits statements and payer responses to identify discrepancies, underpayments, or additional appeal opportunities.
2026-08-13T00:00:00Z

Medical Biller Collector

Los Angeles, CA
onsite
Temporary / Contract
24.01 - 28.99 USD / Hourly
An Eye Surgical Center in Downtown Los Angeles is in the need of a Medical Biller Collector who is looking to make a big step in their career! The Medical Biller Collector will be task with following up with insurance companies on unpaid claims, sending out claims for services rendered, self-pay collections, financial counseling and assisting with various tasks. This amazing company is looking for a Medical Biller Collector who want to be groomed for a supervisor or management role.
2026-08-14T00:00:00Z