Medical Contracting& Credentialing Specialists

Overview

Infusion Health is seeking an experienced Contracting & Credentialing Specialist to manage the full lifecycle of provider credentialing, facility credentialing, and payor and ancillary contracting for vascular practices. This role is the internal subject matter expert for all credentialing and contracting functions and works closely with clinical leadership, billing, and executive management to protect revenue, maintain compliance, and ensure uninterrupted provider participation across all payors and facilities.

This is a mid-level position requiring strong attention to detail, knowledge of healthcare contracting and credentialing processes, and the ability to manage multiple concurrent timelines without oversight.

Key Responsibilities:

Provider Credentialing – Payors, Facilities & Hospitals

Manage end-to-end provider credentialing and re-credentialing with commercial payors, Medicare, Medi-Cal, and Medicare Advantage plans
Process and track facility and hospital privilege applications for all providers
Maintain CAQH, PECOS, NPI, DEA, board certifications, malpractice, and all provider credential documentation
Monitor expiration dates and proactively initiate renewals to prevent lapses in billing eligibility or privileges
Communicate credentialing status to billing, leadership, and facility contacts regularly
Maintain organized, audit-ready credentialing files for all providers
Joint Commission & Facility Accreditation

Support and maintain compliance with Joint Commission accreditation standards
Prepare and organize documentation required for accreditation surveys and site visits
Track accreditation timelines and coordinate internal readiness activities
Serve as a point of contact for accreditation-related inquiries and follow-up
Payor Contracting – Fee-for-Service & Ancillary

Manage end-to-end contracting for fee-for-service payor agreements
Negotiate and execute ancillary service contracts across all applicable service lines
Track contract effective dates, fee schedules, and renewal windows
Ensure all active contracts accurately reflect current participating providers
Partner with billing to verify contracted rates are loaded correctly and reimbursements align with agreements
Maintain a master contract repository with key terms, expiration dates, and amendment history
Payor Contract Renegotiation Support

Assist leadership in preparing for and executing payor contract renegotiations
Pull and organize reimbursement data, utilization reports, and payer performance metrics to support negotiation strategy
Draft correspondence and track outstanding items through the renegotiation process
Coordinate with legal or external consultants as needed during complex negotiations
Provider & Facility Licensing Renewals

Oversee all provider license renewals including state medical licenses, DEA registrations, and specialty certifications
Manage facility licensing renewals and ensure all operational licenses remain current and compliant
Maintain a centralized renewal calendar with proactive alerts and escalation protocols
Coordinate with providers and administration to gather required documentation ahead of deadlines
Medical Records – Secondary Support

Provide secondary support to the medical records function as needed
Assist with record requests, release of information workflows, and documentation compliance
Support audit preparation and medical record organization as directed

Qualifications

3 years of experience in healthcare contracting, credentialing, or a combined role
Demonstrated experience with payor credentialing (Medicare, Medi-Cal, commercial) and facility privileging
Familiarity with Joint Commission accreditation standards and survey preparation
Experience negotiating or supporting renegotiation of payor contracts
Knowledge of fee-for-service and ancillary contracting processes
Proficiency with CAQH, PECOS, NPI Registry, and credentialing management systems
Strong organizational skills and ability to manage multiple deadlines independently
Excellent written and verbal communication skills for payer, facility, and internal correspondence
Healthcare billing knowledge and experience working alongside revenue cycle teams preferred

Education & Certification

Bachelor's Degree in Healthcare Administration, Business, or related field (Preferred)
Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC) (Preferred)
Schedule & Compensation

Monday–Friday, 40 hours/week
Hybrid, Irvine CA 92614
Pay: $30 – $33/hr
Benefits

Health, Dental & Vision Insurance
Paid Time Off

Salary : $30 - $33