Add your latest resume to match with open positions.

3 results for Credentialing Specialist in Thousand Oaks, CA

Medical Credentialing Specialist

Santa Monica, CA
onsite
Temporary to Hire
31.97 - 45 USD / Hourly
A National Hospital System in in Los Angeles is in the immediate need of a Medical Credentialing Specialist to support credentialing and privileging activities for physician staff. This Medical Credentialing Specialist plays an important role in maintaining accurate provider records, supporting compliance efforts, and coordinating documentation for appointment and reappointment workflows. The Medical Credentialing Specialist must bring prior experience in a hospital or healthcare environment, strong working knowledge of MD Staff, and the ability to manage sensitive information with accuracy and care. MD Staff Software is a MUST. Key Responsibilities:• Oversee the end-to-end credentialing cycle for physicians, including new appointments, renewals, and ongoing status maintenance.• Review and validate provider documentation such as licenses, education, certifications, employment history, and references.• Administer privilege requests and updates by tracking clinical privileges and ensuring alignment with governing bylaws and organizational standards.• Maintain complete and current practitioner files within the MD Staff platform, ensuring data accuracy and documentation readiness.• Track expiring credentials and follow up proactively to obtain renewed licenses, certifications, and other required materials before deadlines.• Assemble credentialing packets and prepare supporting materials for review by committees, leadership groups, and governing bodies.• Help uphold adherence to accreditation and regulatory expectations, including Joint Commission standards and internal medical staff requirements.• Serve as a point of contact for physicians, department leaders, and stakeholders regarding application progress, missing items, and approval status.• Contribute to audits, survey preparation, policy revisions, and process improvement initiatives related to medical staff services. Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-05-12T00:00:00Z

Medical Biller/Collections Specialist

Los Angeles, CA
onsite
Temporary to Hire
24 - 28.99 USD / Hourly
A Federally Qualified Health Center (FQHC), is seeking an experienced Medical Biller/Collector to join their revenue cycle team. This Medical Biller/Collector will be responsible for billing, follow-up, and collections activities to ensure timely reimbursement from insurance carriers, government payers, and patients. The ideal candidate for the Medical Biller/Collector role will have strong knowledge of medical billing processes, payer guidelines, and accounts receivable follow-up. Key Responsibilities: Submit accurate and timely medical claims to insurance carriers and government payers Follow up on unpaid, denied, or underpaid claims and resolve billing discrepancies Work accounts receivable reports and maintain collection efforts to reduce outstanding balances Investigate claim rejections and denials, and take corrective action for resubmission or appeal Post payments, adjustments, and denials as needed Communicate with payers, patients, and internal staff regarding billing questions and account resolution Maintain compliance with billing regulations, payer requirements, and organizational policies Support revenue cycle activities including claims review, payment reconciliation, and account research Document collection activity and account status updates accurately in the billing system
2026-05-13T00:00:00Z

Hospital Medical Collections Specialist

Van Nuys, CA
onsite
Temporary to Hire
23.12 - 30.12 USD / Hourly
A Hospital in the San Fernando Valley are looking for an experienced Hospital Medical Collections Specialist. The Hospital Medical Collections Specialist ideal for someone with a strong background in medical revenue cycle activities and a solid understanding of payer follow-up across government and commercial plans. The Hospital Medical Collections Specialist will help drive timely reimbursement by resolving outstanding accounts, addressing denials, and working through appeals for both inpatient and outpatient hospital claims. The hospital is open to candidates with at least 2 years of experience. Responsibilities:• Pursue payment on outstanding hospital accounts by conducting thorough follow-up with insurance carriers and other payers to secure accurate and timely reimbursement.• Review inpatient and outpatient claims to identify billing issues, payment delays, denials, and underpayments, then take appropriate action to move accounts toward resolution.• Manage collection activity across a range of payer types, including Medicare managed care, Medi-Cal managed care, commercial plans, and HMO or PPO coverage.• Prepare and submit appeals, reconsiderations, and supporting documentation to challenge denied or incorrectly processed claims.• Investigate account discrepancies by analyzing billing records, payer responses, and remittance details to determine the next steps for resolution.• Coordinate with internal teams to correct claim information, resolve documentation gaps, and improve the collection of hospital receivables.• Maintain detailed account notes and status updates to ensure clear documentation of collection efforts and payer communications.
2026-05-14T00:00:00Z