Medical Credentialing Specialist

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APS is seeking a detail-oriented and highly organized Medical Credentialing Specialist to join our clients healthcare team. This position is responsible for managing the credentialing and recredentialing process for physicians and allied health professionals, ensuring compliance with federal, state, payer, and accreditation requirements. The ideal candidate has exceptional attention to detail, strong organizational skills, and the ability to manage multiple deadlines in a fast-paced environment.

Location: Salida, CA

Pay Rate: $22-$24/hr 60 day bonus

Requirements:

• High school diploma or equivalent required; Associate's or Bachelor's degree preferred.
• Minimum of 1 year of medical credentialing, provider enrollment, or healthcare administration experience preferred.
• Knowledge of provider credentialing, privileging, and payer enrollment processes.
• Familiarity with Medicare, Medicaid, commercial insurance carriers, and credentialing standards.
• Experience using credentialing software, CAQH, PECOS, and provider enrollment portals.
• Experience in a physician practice, hospital, medical group, or healthcare management organization preferred.
• Knowledge of electronic medical records (EMR) and healthcare information systems.
• Proficiency in Microsoft Office, including Excel, Word, and Outlook.
• Excellent written and verbal communication skills.

Responsibilities:

• Coordinate the initial credentialing, recredentialing, and privileging process for healthcare providers.
• Prepare, submit, and track credentialing applications with commercial insurance carriers, Medicare, Medicaid, and other payer organizations.
• Verify provider education, training, licensure, certifications, work history, malpractice coverage, and professional references.
• Monitor provider licenses, certifications, DEA registrations, malpractice insurance, and other required credentials to ensure timely renewals.
• Maintain accurate and up-to-date provider records in credentialing databases and electronic filing systems.
• Follow up with insurance carriers and credentialing organizations to resolve application issues and expedite approvals.
• Ensure compliance with NCQA, CMS, Joint Commission, state regulations, and payer-specific credentialing requirements.
• Work closely with physicians, practice managers, HR, and administrative staff to obtain required documentation.
• Respond to credentialing audits and maintain complete, audit-ready files.
• Generate reports and provide status updates on credentialing activities and provider enrollment.

Key Competencies

• Detail-oriented and accurate
• Strong organizational and time management skills
• Analytical problem-solving abilities
• Deadline-driven with strong follow-through
• Excellent customer service and communication
• Ability to work independently and collaboratively
• High level of integrity and confidentiality
• 11161

#IND3

Pay: $22.00 - $24.00 per hour

Application Question(s):

• Are you detail-oriented?

Education:

• High school or equivalent (Required)

Experience:

• medical credentialing: 1 year (Required)

License/Certification:

• Certified Provider Credentialing Specialist (CPCS) (Preferred)

Work Location: In person

Salary : $22 - $24