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 serve as a key contact for practitioner status inquiries while working remotely.

Key responsibilities:

• Request and review primary source information and verifications, identifying and resolving gaps in vendor relationships
• Process provider enrollment by gathering and reviewing information for application submissions 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 with at least three years of relevant experience, or four years of experience in a directly related field
• Minimum one year of experience with databases and spreadsheets
• Provider Credentialing Specialist Certificate within 36 months of hire
• Experience in clinical credentialing, accreditation, and regulation
• Knowledge of health care compliance and quality standards