Credentialing Specialist
Job in
Laguna Woods, Orange County, California, 92637, USA
Listed on 2026-02-28
Listing for:
Medix™
Full Time
position Listed on 2026-02-28
Job specializations:
-
Healthcare
Healthcare Administration, Healthcare Management, Medical Office
Job Description & How to Apply Below
Our client is seeking an experienced Credentialing Specialist to manage the high‑stakes privileging and enrollment processes for a busy orthopedic and multi‑specialty surgical group. You will be the primary point of contact for surgeons, hospitals, and payers to ensure uninterrupted clinical operations.
Core Responsibilities- Surgical Privileging: Coordinate OR privileges at hospitals and ASCs for orthopedic procedures (Total Knee, Arthroscopic repairs, etc.).
- Provider Enrollment: Manage Medicare/Medicaid and private payer enrollment via PECOS and CAQH to prevent claim issues.
- Primary Source Verification: Verify education and fellowships through ABOS
. - Compliance: Monitor and renew State Medical Licenses, DEA registrations, and Malpractice Insurance.
- Experience: 2–4 years in medical credentialing (Surgical or Multi‑specialty experience preferred).
- Systems: Proficiency with Modio and a background in large medical group settings is a plus.
- Education: High School Diploma required;
Degree in Healthcare Admin preferred. - Traits: High attention to detail and a self‑starter mindset.
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