California Licensed Credentialing Specialist

Job Summary

To support credentialing processes, the full-time temporary California Licensed Credentialing Specialist will manage primary source verifications, evaluate applications, and maintain databases while working remotely.

Key responsibilities:

• Request and review primary source information and verifications, identifying gaps in vendor relationships
• Process provider enrollment by gathering and reviewing information for submission to payors
• Assist in quality assurance and compliance by evaluating practitioner sanctions and participating in audits of credentialing entities

Required qualifications:

• Associates degree in Business Administration, Health Care Administration, Nursing, Public Health, or related field AND a minimum of three years of experience in clinical credentialing or a related field, or four years of experience in the same areas
• Minimum one year of experience with databases and spreadsheets
• Provider Credentialing Specialist Certificate within 36 months of hire