Credentialing Specialist (Medi-Cal, Anthem CA, Kaiser Experience Required)

Remote, USA Full-time
About UsWe are a growing healthcare organization committed to delivering exceptional patient care through innovative and collaborative clinical services. As we expand our partnerships across California, we are looking for a detail-oriented and experienced Credentialing Specialist to join our team and help ensure timely and accurate provider onboarding with payers.Position OverviewThe Credentialing Specialist will manage and execute all aspects of the credentialing process for healthcare providers. The ideal candidate has hands-on experience with Medi-Cal (California Medicaid), Anthem Blue Cross of California, and Kaiser Permanente, and can confidently navigate the submission, follow-up, and troubleshooting processes required by these payers.Key Responsibilities1. Prepare, submit, and track credentialing and re-credentialing applications for providers across Medi-Cal, Anthem CA, and Kaiser.2. Monitor credentialing timelines and proactively follow up with payers to avoid delays.3. Serve as the primary point of contact for credentialing-related communications with health plans and internal teams.4. Identify and escalate issues or delays as needed, and support resolution efforts to ensure timely approvals.5. Stay up to date with changes in payer policies and credentialing requirements.Requirements1. Minimum 2 years of credentialing experience in a healthcare setting.2. Direct experience credentialing providers with Medi-Cal, Anthem Blue Cross of California, and Kaiser Permanente.3. Experience credentialing behavioral-health providers.4. Strong understanding of payer-specific requirements, CAQH, and NPPES systems.5. Excellent attention to detail, organizational skills, and follow-through.6. Proficiency in Google Workspace (Docs, Sheets) or Microsoft Office Suite.Strong communication skills and ability to work independently and collaboratively. Apply To This Job
Apply Now

Similar Jobs

Clinical Auditor RN Utilization Management, Remote Nationwide – bolthires Store

Remote, USA Full-time

EngagedMD: Fertility Clinical Workflow Manager

Remote, USA Full-time

State College, PA Event Staff Needed: $25-$30 per hour in State College, PA in Stafftacular (job Id: 1691015543)

Remote, USA Full-time

Tech Academies by Manpower Digital | Talent Pool - Full-time

Remote, USA Full-time

Kelly Services Materials Database Analyst/Coordinator – Remote in Raynham, Massachusetts

Remote, USA Full-time

Remote Compliance Auditor

Remote, USA Full-time

Experienced Customer Experience Agent – Remote Work Opportunity for Delivering Exceptional Client Support and Driving Business Growth

Remote, USA Full-time

Experienced Principal Engineer - Data Analytics & Data Science Leader for Strategic Vision and Technical Direction at blithequark

Remote, USA Full-time

Experienced Part-Time Customer Service Representative – Remote Position for Blithequark Member Service Center

Remote, USA Full-time

Experienced Licensed Insurance Professional - Gold Customer Service Representative for Delivering Exceptional Client Experiences and Driving Business Growth

Remote, USA Full-time

**Experienced Full Stack Data Entry Specialist – Cloud Application Development and Customer Support**

Remote, USA Full-time

Experienced Data Entry Specialist for Books and Periodicals – Utilizing Foreign Language Skills for Global Information Services at blithequark

Remote, USA Full-time

Dental Assistants

Remote, USA Full-time

IT Service Desk Technician

Remote, USA Full-time

Clinical Pharmacist Virtual Pharmacy Services Order Verification Atrium Health SouthEast Region FT

Remote, USA Full-time

Experienced YouTube Moderator and Marketing Specialist – Remote Work Opportunity with Competitive Hourly Rate of $26

Remote, USA Full-time

Inside Sales Agent - Remote

Remote, USA Full-time

blithequark Virtual Assistant Jobs – Women Friendly – No Degree Required

Remote, USA Full-time

**Experienced Virtual Assistant/Data Entry Junior (Part-Time) – Flexible Work-From-Home Opportunity for Data Management Professionals**

Remote, USA Full-time

Clinical Trial Lead/Clinical Research Associate | Vial | $90k-$95k | Remote (USA)

Remote, USA Full-time
Back to Home