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4 results for Denials Specialist in Thousand Oaks, CA

Credentialing Specialist

Santa Monica, CA
onsite
Temporary / Contract
32 - 45 USD / Hourly
We are looking for a Credentialing Specialist to support credentialing and privileging activities for physician staff in Santa Monica, California. This Credentialing Specialist plays an important role in maintaining accurate provider records, supporting compliance efforts, and coordinating documentation for appointment and reappointment workflows. The ideal candidate brings 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. Key Responsibilities:<ul><li>Oversee the end‑to‑end credentialing cycle for physicians within an MSO‑supported, multi‑site environment, including new appointments, renewals, and ongoing provider status maintenance.</li><li>Review and validate provider documentation such as licenses, education, certifications, employment history, references, and malpractice coverage, ensuring alignment with MSO, payer, and organizational standards.</li><li>Administer privilege requests and updates by tracking clinical privileges across affiliated practices and service locations, ensuring consistency with governing bylaws, MSO policies, and medical staff requirements.</li><li>Maintain complete, accurate, and current practitioner files within the MD Staff platform, supporting MSO credentialing operations, data integrity, and audit readiness.</li><li>Track expiring credentials and proactively follow up to obtain renewed licenses, certifications, and supporting documentation needed for MSO participation and payer enrollment continuity.</li><li>Assemble credentialing and re‑credentialing packets for review by medical staff committees, leadership groups, and MSO governance bodies.</li><li>Support compliance with Joint Commission, NCQA, CMS, and MSO‑specific accreditation and regulatory standards.</li><li>Serve as a primary point of contact for physicians, department leaders, MSO stakeholders, and affiliated practices regarding application status, missing items, and approval timelines.</li><li>Contribute to audits, survey preparation, policy updates, and process improvement initiatives related to MSO credentialing, provider enrollment, and medical staff services.</li></ul> Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
2026-04-25T00:00:00Z

Medical Eligibility Specialist

Long Beach, CA
onsite
Temporary to Hire
18.2115 - 23 USD / Hourly
A Medical Center in Long Beach is in the immediate need of Medical Eligibility Specialist. The Medical Eligibility Specialist will play a vital role in ensuring accurate financial screening, eligibility and insurance verification for incoming patients. The Medical Eligibility Specialist ideally will have strong experience in eligibility, microsoft excel and medi-cal insurance. Responsibilities:• Conduct financial screenings for incoming clients to determine eligibility and financial liability.• Verify Medi-Cal coverage and other insurance eligibility to ensure proper documentation and accurate billing.• Maintain and update client financial records in electronic health record systems.• Organize and track annual re-evaluations of client financial information.• Follow up with clinical staff to ensure completion of required documentation for financial folders.• Collect and manage client documents, such as Medi-Cal cards, social security cards, and identification cards.• Create and oversee electronic insurance folders, including adjustments, claims, and explanation of benefits (EOBs).• Audit financial folders upon client discharge to ensure compliance and accuracy.
2026-04-30T00:00:00Z

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.
2026-05-04T00:00:00Z

Routing Specialist

South Gate, CA
onsite
Temporary to Hire
21 - 24 USD / Hourly
We are looking for a Routing Specialist to support logistics operations in California. This contract opportunity with potential for a permanent position is ideal for someone who can organize transportation activity, maintain shipment visibility, and keep delivery plans on schedule in a fast-moving environment. The role works closely with drivers, warehouse teams, and business partners to improve routing efficiency, track freight activity, and maintain accurate operational records. Responsibilities: • Build and adjust daily routing plans to improve transit efficiency and support on-time delivery performance. • Use Excel and logistics systems to track shipments, analyze transportation data, and prepare operational reports. • Coordinate with drivers, dispatch, warehouse staff, and external partners to keep freight moving according to schedule. • Monitor loads in transit, identify service disruptions early, and take action to resolve delays or exceptions. • Maintain organized records related to routes, shipment activity, billing details, and transportation costs. • Communicate status updates clearly to internal stakeholders and customers while supporting a high level of service. • Support compliance with transportation procedures, customer requirements, and applicable industry regulations. • Work within business platforms such as ERP, CRM, and CargoWise to manage logistics information accurately.
2026-04-24T00:00:00Z