Credentialing Specialist Job at Robert Half, Palm Springs, CA

amlIS3F3ZWhYdzIxVG5aeHB6Q3hMUkRtZ0E9PQ==
  • 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, Long term contract,

Similar Jobs

United Parcel Service

Warehouse Worker - Package Handler Job at United Parcel Service

 ...job offer in 10 minutes! The steps are simple: 1) Provide some basic information to start the application process. 2) Watch a short video to see what the job is like. 3) Complete our online application process. 4) Receive your job offer and schedule your first... 

US Tech Solutions

Clinical Research Associate (CRA) I Job at US Tech Solutions

 ...Job Description Duration: 12 months contract Description: Name of Functional Area/Department: Clinical Pharmacology & Pharmacometrics Research Unit Open 24/7, will work 8-hour shifts. There is no guarantee of hours. Some weeks may have no shifts whereas... 

LeaderStat

Travel Wound Care Nurse (RN) - $2,191 per week Job at LeaderStat

 ...LeaderStat is seeking a travel nurse RN Wound Care for a travel nursing job in Silver Spring, Maryland. Job Description & Requirements ~ Specialty: Wound Care ~ Discipline: RN ~ Start Date: ASAP ~ Duration: 13 weeks ~36 hours per week ~ Shift: 12 hours... 

Placers Professional, a division of Placers

Controller Job at Placers Professional, a division of Placers

 ...candidates to ensure they are the right fit. Negotiating offers and guiding new hires through the onboarding process. Manage talent pipelines and maintain strong candidate relationships. Staying up to date on industry trends and best practices in recruitment.... 

NYL Ragsdale Group

Life Insurance Sales Agent Job at NYL Ragsdale Group

 ...Strategies LLC, a Registered Investment Adviser. Registered Representatives offer securities through NYLIFE Securities LLC (member FINRA/SIPC), A Licensed Insurance Agency - Equal Opportunity Employer M/F/D/V Compensation: $75,000 at plan Responsibilities: Commit...