A Healthcare Company in Long Beach in looking to hire a Credentialing Specialist to support provider enrollment and credentialing activities. The Credentialing Specialist is ideal for someone who can step into a fast-paced healthcare environment to help maintain accurate, compliant credentialing records. The Credentialing Specialist will play an important part in keeping provider files current, complete, and ready for timely onboarding and activation.
Key Responsibilities:
- Manage credentialing and recredentialing case files by gathering, reviewing, and organizing provider documentation for completeness and accuracy.
- Communicate with providers and practice contacts to obtain outstanding materials and resolve incomplete submissions in a timely manner.
- Conduct and coordinate primary source verification for items such as licensure, certifications, education history, sanctions screening, and malpractice coverage or claims history.
- Support provider onboarding efforts by tracking packet status and helping move applications through the credentialing workflow efficiently.
- Enter, update, and maintain credentialing data within internal systems to ensure records remain current and reliable.
- Monitor key operational indicators, including missing file components, upcoming renewal deadlines, processing turnaround times, and open backlog items.
- Assist with audit preparation and file quality reviews to support compliance with organizational, state, and health plan standards.
- Verify provider demographic details and roster information while also helping with backlog reduction, document indexing, scanning, and other administrative support tasks.
Benefits: Medical, Dental and Vision Insurance. 401K Retirement, Sick Time Off and Tuition Reimbursement.
Qualifications:
- Hands-on experience with provider credentialing, physician credentialing, or recredentialing in a healthcare setting.
- Working knowledge of credentialing workflows, documentation standards, and primary source verification practices.
- Strong attention to detail with the ability to identify missing information and maintain highly accurate records.
- Comfortable following up with providers and practice staff to obtain required documents and clarify discrepancies.
- Proficiency with data entry and credentialing systems, with the ability to manage a high volume of files efficiently.
- Ability to work onsite in Long Beach, California, Monday through Friday with no remote or hybrid schedule.
- Availability to begin immediately and contribute during a 3- to 6-month assignment with potential for extension.