Credentialing Specialist Job at Robert Half, Palm Springs, CA

V3ErQWhTc09XK3FtSlE2cnptK25Qa3JOdlE9PQ==
  • Robert Half
  • Palm Springs, CA

Job Description

Description We are looking for a dedicated Credentialing Specialist to join our team in Palm Springs, California. This long-term contract position is ideal for someone with a strong attention to detail and a solid background in healthcare credentialing and compliance. The role involves ensuring providers meet managed care requirements and adhere to California-specific regulations. Responsibilities: - Manage the initial credentialing and recredentialing processes for healthcare providers, ensuring compliance with relevant standards and guidelines. - Verify provider qualifications, including licenses, certifications, education, and work history, in line with California state regulations. - Maintain a thorough understanding of managed care policies and contracts to ensure proper credentialing procedures. - Ensure adherence to standards set by regulatory organizations such as the National Committee for Quality Assurance (NCQA), The Joint Commission, and Centers for Medicare & Medicaid Services. - Maintain accurate and up-to-date credentialing records, performing regular audits to ensure data integrity. - Act as the primary point of contact for providers, managed care organizations, and regulatory agencies, resolving inquiries and providing guidance on credentialing requirements. - Oversee the renewal process for provider contracts and credentials, addressing any appeals or disputes as needed. - Identify opportunities to streamline credentialing workflows and implement improvements in line with regulatory updates. - Monitor compliance with California-specific licensing and managed care guidelines, ensuring readiness for audits. - Stay informed about changes in healthcare regulations and adjust credentialing processes accordingly. Requirements - Associate's or Bachelor's degree in healthcare administration, business, or a related field, or equivalent experience. - At least 2-3 years of experience in credentialing, preferably within a managed care or healthcare organization. - Proficiency with electronic health record (EHR) systems and credentialing software. - Strong understanding of California-specific healthcare credentialing laws and managed care requirements. - Familiarity with standards from NCQA, The Joint Commission, and other regulatory bodies. - Excellent organizational skills and attention to detail. - Strong communication abilities, both verbal and written, with the capability to manage multiple priorities. - Certification as a Certified Provider Credentialing Specialist (CPCS) is highly preferred. TalentMatch® Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app ( and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking "Apply Now," you're agreeing to Robert Half's Terms of Use ( .

Job Tags

Permanent employment, Contract work, Temporary work,

Similar Jobs

Group 1 Automotive

Automotive Technician/Mechanic - Ira Toyota Saco Job at Group 1 Automotive

Overview: **Join the Elite Team at Ira Toyota Saco!** Compensation: $40-45 per Flat Rate Hour (FRH) - Industry Leading Pay** Ira Toyota Saco is part of the fast growing Group 1 Automotive, a leader in automotive retail and service. Are you a talented and... 

Relevante

House Parent Job at Relevante

 ...Salary: $37,700.00 We have partnered with a non-profit organization in the Amarillo, TX area to provide them with a House Parent. Please review the below description and let us know if you are interested. Prioritized Must Have Skills for the House Parent... 

NexCare WellBridge Senior Living

MDS Nurse - Part Time - $34.15 per hour Job at NexCare WellBridge Senior Living

 .... The MDS Nurse is responsible for the timely and accurate completion of the Resident Assessment...  ...to requirements. This position will be Part-Time MDS Nurseand Part-Time Floor Nurse....  ...: Competitive Wages starting at $34.15 per hour Yearly Wage Increases PLUS we offer... 

MCI

Remote Outbound Sales Representative Job at MCI

 ...industry. We are looking for Outbound Sales Representatives to support a variety of projects...  ...year of experience in customer service, technical support, inside sales, back-office, chat,...  ...Must be willing to submit up to a LEVEL II background and/or security investigation... 

KLAS Enterprises

Editor Job at KLAS Enterprises

 ...KLAS is looking to hire an outstanding editor to refine research-collected commentary for publication. As an Editor, you will confirm...  ...Schedule: Our hybrid work policy allows team members to work both remotely and in the office. This flexible approach provides team members...