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5 results for Credentialing Auditor in Monterey Park, CA

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.
2026-08-03T00:00:00Z

Check Auditor

El Segundo, CA
onsite
Temporary to Hire
20 - 22 USD / Hourly
Our client is seeking a detail-oriented Check Auditor to join their Accounting team on a contract assignment. This is an excellent opportunity for someone with Accounts Payable or accounting experience who enjoys working in a fast-paced environment where accuracy and organization are essential. Responsibilities<ul><li>Audit vendor checks against supporting documentation to ensure payment information, addresses, and dollar amounts are accurate.</li><li>Manage the daily check printing process.</li><li>Monitor and maintain the backup check printer to ensure business continuity.</li><li>Cross-train team members on check printing and auditing procedures.</li><li>File invoices and maintain organized accounting records.</li><li>Ensure established processes, procedures, and internal controls are consistently followed.</li><li>Assist with special projects and other accounting-related tasks as assigned.</li></ul>
2026-08-05T00:00:00Z

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 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

Insurance Verifier

Encino, CA
onsite
Temporary to Hire
24 - 27 USD / Hourly
A healthcare company is looking for an Insurance Verifier to support pre-service financial clearance for surgical patients in California. This Insurance Verifier focuses on confirming coverage details, identifying authorization needs, and helping patients understand their expected financial responsibility before scheduled procedures. The Insurance Verifier will work closely with clinical, scheduling, and revenue cycle teams to reduce avoidable claim issues and keep cases on track for timely treatment. Key Responsibilities:• Conduct pre-procedure insurance reviews to confirm active coverage and validate plan benefits for scheduled surgical services.• Assess deductibles, copayments, coinsurance amounts, out-of-pocket limits, and any exclusions that may affect patient liability.• Determine when prior authorization or referral approval is required and record all supporting details for follow-up by the appropriate teams.• Examine scheduled services and provider documentation to ensure payer rules and coverage criteria are satisfied before the surgery date.• Prepare clear cost estimates for patients and explain expected financial obligations with professionalism and empathy.• Enter complete and accurate verification findings into the electronic medical record and related practice management tools.• Partner with scheduling, admissions, clinical, and billing personnel to resolve benefit discrepancies or missing information ahead of treatment.• Escalate potential coverage concerns quickly so patients and care teams can address issues before delays or cancellations occur.• Maintain thorough records of payer communications, verification activity, and authorization status while following applicable compliance standards. Benefits: Health, Dental, Vision, 401k, and Sick Time Off.
2026-08-05T00:00:00Z