Credentialing Specialist
Rancho Health
- Temecula, California, United States
- Temecula, California, United States
About
Manage initial credentialing and recredentialing for providers with commercial and government payers Prepare and submit credentialing applications, ensuring completeness and accuracy Track application status and proactively follow up with payers to ensure timely processing Maintain provider records in credentialing systems and databases Monitor and manage expirables (licenses, certifications, malpractice insurance, etc.) Assist with payer roster submissions and directory updates Support enrollment for new providers, new locations, and additional TINs Serve as a liaison between internal departments (RCM, operations, compliance) and external payers Provide administrative support to the Senior Credentialing Specialist, including documentation management and reporting Identify and escalate issues that may impact provider enrollment or revenue cycle performance Contribute to process improvements and standardization efforts
Qualifications:
2+ years of credentialing or payer enrollment experience in a healthcare setting Knowledge of commercial and government payer credentialing requirements Experience working with multiple TINs and provider groups preferred Familiarity with credentialing systems (e.g., CAQH, PECOS, or similar platforms) Strong organizational skills and attention to detail Ability to manage multiple priorities and meet deadlines Effective communication and follow-up skills
Skills & Abilities:
Detail-oriented and process-driven Strong problem-solving skills Ability to work independently and collaboratively Proactive and accountable Adaptable in a fast-paced, growing environment
This is a hybrid role based in Riverside, CA. Onsite presence is required on a regular basis, with flexibility to work remotely based on business needs. Mon - Fri (hours based on business needs)
Languages
- English
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