Medical Credentialing Specialist Job at Robert Half (Santa Monica)

Medical Credentialing Specialist

A National Hospital System in in Los Angeles is in the immediate need of a Medic...

Location

United States , Santa Monica

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 3 years of experience in medical staff services, provider credentialing, or privileging within a hospital or healthcare setting
Hands-on experience using MD Staff software in a credentialing or medical staff administration environment
Solid understanding of physician credentialing practices, reappointment procedures, and privileging requirements
Working knowledge of healthcare regulatory and accreditation standards, including Joint Commission expectations and medical staff bylaws
Strong organizational skills with the ability to manage multiple deadlines and maintain a high level of accuracy
Effective written and verbal communication skills for working with providers, committees, and administrative leadership
Ability to handle confidential information with discretion and professionalism

Job Responsibility

Oversee the end-to-end credentialing cycle for physicians, including new appointments, renewals, and ongoing status maintenance
Review and validate provider documentation such as licenses, education, certifications, employment history, and references
Administer privilege requests and updates by tracking clinical privileges and ensuring alignment with governing bylaws and organizational standards
Maintain complete and current practitioner files within the MD Staff platform, ensuring data accuracy and documentation readiness
Track expiring credentials and follow up proactively to obtain renewed licenses, certifications, and other required materials before deadlines
Assemble credentialing packets and prepare supporting materials for review by committees, leadership groups, and governing bodies
Help uphold adherence to accreditation and regulatory expectations, including Joint Commission standards and internal medical staff requirements
Serve as a point of contact for physicians, department leaders, and stakeholders regarding application progress, missing items, and approval status
Contribute to audits, survey preparation, policy revisions, and process improvement initiatives related to medical staff services

What we offer

Medical
Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Fulltime

Medical Credentialing Specialist

The Robert Half Healthcare Practice is working with a healthcare network to brin...

Location

United States , Indianapolis

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Must have Payer enrollment experience
Must have Primary Source Verification (PSV) experience
Must know how to use the following Credentialing software, PECOS, Medicare and Medicaid Enrollments for both provider and Facility, MPPES, CAQH and Excel
Knowledge of working with National Payors (UHC, Anthem BCBS, Etc)
Must know how to manage reports
Must have knowledge of working claims and denials
Bachelors and a CPCS preferred

Job Responsibility

Provider Credentialing: Review provider credentials, maintain accurate electronic data, and complete ARMS credentialing and re-credentialing
Payer Enrollment: Complete, monitor, and follow up on provider credentialing and payer enrollment with all commercial, Medicaid, Medicare, and Medicaid managed care payers
Data Management: Maintain CAQH, NPPES/PECOS, and state license information for all providers
Risk Management: Obtain and maintain malpractice coverage, EMR licenses, and signed physician contracts
Compliance: Ensure compliance with the affiliate, state, and federal regulations
Equity and Accountability: Demonstrate commitment to health equity, racial equity, and continuous improvement

What we offer

medical, vision, dental, and life and disability insurance
eligible to enroll in our company 401(k) plan
free online training

Fulltime

Credentialing Specialist I - Medical Staff

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED), or an equivalent combination of relevant education and experience
None required. One (1) year experience performing medical staff credentialing or similar related tasks preferred
None required
Knowledge and ability to understand what credentialing of medical health care providers entails
Knowledge and ability to understand, policy and procedures, regulations, statues, and laws as it relates to documents required for credentialing
Ability to organize and prioritize all assigned tasks and workloads in a busy work environment
Ability to brief leadership in a timely manner on status of workload, projects, priorities, barriers, or issues to ensure assignments are on track
Skill in the use of Microsoft Office products, especially Word and EXCEL
Ability to review and monitor various forms of detailed credentialing information to ensure compliance with departmental procedures
Ability to draft reports, business correspondence, and procedure manuals

Job Responsibility

Verifies medical training, experience and other attributes required of medical health care providers. Ensures the completion of files and monitors expired documents during the members' appointment period
Assists Credentialing Specialists and Leadership with the credentialing and recredentialing process
Reviews applications and other data for accuracy and completeness
Performs and collects primary source verification and other documents needed including follow-up activities of initial and reappointments applications
Enter credentialing and privileging data timely and accurately into the credentialing database
Ensures good working relationships with clinical departments, Medical Staff leadership and professional agencies
Assists in compliance with the accrediting and regulatory agencies regarding credentialing, while developing and maintaining a working knowledge of the required statutes and laws
Answers phones, assist with committee support, make copies, prepare mailings, and maintain files
Adheres to TMCH organizational and department-specific safety, confidentiality, values, policies, and standards
Performs related duties as assigned

Fulltime

Credentialing Specialist II-Medical Staff

Performs and monitors all credentialing functions, including complex credentiali...

Location

United States , Tucson

Salary:

Not provided

Tucson Medical Center

Expiration Date

Until further notice

Requirements

High school diploma or general education degree (GED)
Two (2) to Four (4) years of medical staff privileging or credentialing experience
CPCS or CPMSM certification preferred
Intermediate to Advanced Knowledge of healthcare practices and procedures
Advanced Skills in maintaining a detailed database, creating reports, and maintaining files
Intermediate to Advanced Ability to read, analyze, and interpret general business periodicals, professional journals, technical and software related procedures and manuals, governmental regulations
Display promotes and inspires trust and confidence among team members and stakeholders through reliability, authenticity, and accountability
Expresses thoughts clearly, concisely, and effectively both verbally and in writing
Establishes and maintains productive and cooperative relationships with team members, peers, management, and stakeholders both internal and external to the organization
Intermediate to Advanced ability to effectively present information and respond to inquiries regarding any issue related to the Credentialing and Privileging process

Job Responsibility

Performs and monitors all credentialing functions, including complex credentialing issues and brings forward issues to the Medical Staff Credentialing Lead and/or Director
Interfaces with senior medical staff leaders and administration and presents information when necessary
Utilizes knowledge of bylaws, rules, and regulations, expertise, sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Acts as a liaison between Administration and members of the Medical Staff
Apply knowledge, expertise, sound judgment and consult other references and resources as necessary to generate and evaluate solutions and recommendations
Applies knowledge of bylaws, rules, and regulations to effectively serve as a Medical Staff information resource, to ensure timely flow of work, and sound judgment to mentor and support Medical Staff Credentialing Specialists I, other peers, and leadership
Ensures compliance with all applicable Accreditation agencies
Supports oversite and participate in internal, external, compliance surveys, reviews and audits as required
Utilizes credentialing software for new and reappointment letters, resignations, leave of absences, changes in staff category, add/delete privileges
Coordinates, monitors and maintains the credentialing and recredentialing process

Fulltime

Credentialing Specialist

We are seeking a Credentialing Specialist for a short term contract in Nashville...

Location

United States , Nashville

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

High school diploma or equivalent (Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred)
1–3 years of experience in healthcare credentialing, provider enrollment, or medical staff services
Knowledge of payer enrollment processes (Medicare, Medicaid, commercial payers)
Familiarity with credentialing standards and regulatory requirements
Proficiency with credentialing software, provider databases, and Microsoft Office (Excel, Word, Outlook)
Strong organizational skills with high attention to detail
Excellent written and verbal communication skills

Job Responsibility

Coordinate and process initial credentialing, recredentialing, and payer enrollment for healthcare providers
Collect, verify, and maintain provider documentation including licenses, certifications, education, training, work history, NPIs, and DEA registrations
Prepare and submit credentialing and enrollment applications to insurance payers, hospitals, and regulatory bodies
Monitor credential expirations and proactively manage renewals to maintain continuous provider eligibility
Maintain accurate and up‑to‑date credentialing records in credentialing software and internal databases
Serve as a liaison between providers, payers, medical staff offices, and internal departments
Track application statuses, follow up on outstanding items, and resolve credentialing or enrollment issues
Ensure compliance with CMS, NCQA, Joint Commission, state, and payer credentialing requirements
Support audits and accreditation reviews by preparing and providing credentialing documentation
Maintain strict confidentiality of sensitive provider information

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Credentialing Specialist

We are looking for a Credentialing Specialist to support provider enrollment and...

Location

United States , Plainview

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Prior experience in medical credentialing, provider enrollment, healthcare administration, or a closely related field
Working knowledge of physician or provider credentialing, including initial credentialing and re-credentialing processes
Strong organizational skills with a high level of accuracy when reviewing sensitive records and documentation
Ability to communicate clearly with providers, administrators, and cross-functional stakeholders
Comfortable using web-based systems, databases, and credentialing applications in a structured setting
Capacity to manage multiple assignments, monitor deadlines, and adjust priorities as needed
Familiarity with healthcare compliance standards, licensing requirements, and credentialing regulations is preferred

Job Responsibility

Manage credentialing activities from initial intake through renewals and periodic reappointments for healthcare providers across multiple practices
Examine licenses, certifications, education records, training details, and employment history to confirm accuracy and completeness
Maintain organized and up-to-date provider information within a secure web-based credentialing platform
Partner with physicians, providers, and practice contacts to collect missing documents and resolve inconsistencies in submitted materials
Track application progress and follow up proactively to support timely completion and adherence to required deadlines
Apply current regulatory and accreditation guidelines to daily credentialing work and escalate issues when compliance concerns arise
Prepare recurring updates and summary reports for leadership and compliance stakeholders regarding credentialing status and outstanding items
Serve as a knowledgeable resource for credentialing-related questions across affiliated practices and internal teams

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Credentialing Specialist

We are looking for a Credentialing Specialist to support credentialing and privi...

Location

United States , Santa Monica

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 3 years of experience in medical staff services, provider credentialing, or privileging within a hospital or multi‑site healthcare setting, including environments supporting affiliated practices or provider groups
Hands‑on experience using MD Staff software in a credentialing, medical staff administration, or provider services environment
Solid understanding of physician credentialing practices, reappointment procedures, and privileging requirements across complex clinical settings
Working knowledge of healthcare regulatory and accreditation standards, including Joint Commission expectations and medical staff bylaws
Strong organizational skills with the ability to manage multiple deadlines, track expirables, and maintain a high level of accuracy
Effective written and verbal communication skills for working with providers, committees, administrative leadership, and operational stakeholders
Ability to handle confidential information with discretion and professionalism
Industry certification such as CPCS or CPMSM is preferred, and experience supporting medical staff or credentialing committees is a plus

Job Responsibility

Oversee the end‑to‑end credentialing cycle for physicians within an MSO‑supported, multi‑site environment, including new appointments, renewals, and ongoing provider status maintenance
Review and validate provider documentation such as licenses, education, certifications, employment history, references, and malpractice coverage, ensuring alignment with MSO, payer, and organizational standards
Administer privilege requests and updates by tracking clinical privileges across affiliated practices and service locations, ensuring consistency with governing bylaws, MSO policies, and medical staff requirements
Maintain complete, accurate, and current practitioner files within the MD Staff platform, supporting MSO credentialing operations, data integrity, and audit readiness
Track expiring credentials and proactively follow up to obtain renewed licenses, certifications, and supporting documentation needed for MSO participation and payer enrollment continuity
Assemble credentialing and re‑credentialing packets for review by medical staff committees, leadership groups, and MSO governance bodies
Support compliance with Joint Commission, NCQA, CMS, and MSO‑specific accreditation and regulatory standards
Serve as a primary point of contact for physicians, department leaders, MSO stakeholders, and affiliated practices regarding application status, missing items, and approval timelines
Contribute to audits, survey preparation, policy updates, and process improvement initiatives related to MSO credentialing, provider enrollment, and medical staff services

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Fulltime

Credentialing Specialist

The Credentialing Specialist is responsible for supporting the credentialing, re...

Location

United States , West Hollywood

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience in healthcare administration, credentialing, provider enrollment, or medical staff services preferred
Familiarity with provider credentialing, compliance, or payer enrollment processes is a plus
Strong attention to detail and ability to manage multiple deadlines and tracking requirements
Proficiency with Microsoft Office Suite, especially Excel
Experience using credentialing or healthcare systems/databases preferred
Strong written and verbal communication skills
Ability to handle confidential and sensitive information with discretion
Knowledge of HIPAA, regulatory standards, and healthcare documentation practices preferred
Certification (e.g., CPCS, CPMSM) is a plus but not required

Job Responsibility

Coordinate and manage initial credentialing and re‑credentialing for healthcare providers
Collect, review, and maintain provider documentation (licenses, certifications, education, work history, malpractice coverage, etc.)
Perform primary source verification in accordance with regulatory and organizational standards
Track license, certification, and enrollment expiration dates to ensure ongoing compliance
Maintain accurate provider records within credentialing databases and internal systems
Communicate with providers and internal stakeholders regarding application status and missing documentation
Assist with payer enrollment and revalidation processes, as assigned
Support audits and ensure credentialing files are complete and compliant
Maintain confidentiality and comply with HIPAA and regulatory requirements
Perform additional administrative or credentialing support duties as needed

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement
medical, vision, dental, and life and disability insurance
company 401(k) plan

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Medical Credentialing Specialist

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