Credentialing Specialist Job at Nexus HR Services, Los Angeles, CA

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  • Nexus HR Services
  • Los Angeles, CA

Job Description

Credentialing Specialist - Los Angeles, CA

Compensation: $45,000 - $55,000 per year DOE

Overview: Nexus HR is looking for a Credentialing Specialist in Los Angeles, CA. The ideal candidate will be responsible for overseeing and managing the credentialing processes for healthcare professionals within the organization. 

About the Job

The Credentialing Specialist will help maintain providers’ compliance to legal regulations and accreditation. They will serve as the bridge that facilitates credentialing needs for the clinic’s medical providers and the organizing/credentialing/accrediting organizations. The Credentialing Specialist will be involved in the application and the maintenance of the credentialing of all medical providers as well as managing medical records and files. 

Duties and Responsibilities:

  • Create and maintain files of all medical providers, form physicians to mid-level providers, to medical assistants, both hard and soft copies. 

  • Create and maintain files for credentialing applications and renewals.

  • Process and track new applications and renewal applications for all medical providers.

  • Coordinate with billing and management to monitor and resolve any denials or any issues with authorization related to provider credentials.

  • Maintain a provider database and other important credentialing records.

  • Keep up to date with the latest credentialing legislation and industry standards.

  • Manage medical records and files

  • All other tasks assigned.

Qualifications :

  • At least high school diploma or GED equivalent

  • 2 years of experience in credentialing or comparable work experience

  • 1 year of experience working in the healthcare industry

  • Familiarity with California credentialing statutes and regulations

  • Strong knowledge of credentialing process and procedures

  • Familiarity with EHR/EMR softwares

  • Excellent customer service towards colleagues and providers.

  • Able to work in Los Angeles, CA

  • Authorized to work in the US

Benefits:

  • Dental

  • Vision

  • Medical

  • 401k 

  • Paid Leave

Job Tags

Work experience placement,

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