Insurance Credentialing Coordinator

6 days ago

Los Angeles, California, United States NAPA Center Full time
Job Title: Insurance Credentialing Specialist

Job Summary:

NAPA Center is seeking a highly organized and detail-oriented Insurance Credentialing Specialist to oversee the credentialing and re-credentialing process for our therapists. This role is responsible for managing applications, renewals, and maintaining accurate credentialing records in relevant databases. The successful candidate will work closely with therapists and insurance providers to resolve any credentialing issues, ensuring compliance with all legal and insurance standards.

Key Responsibilities:

  • Manage enrollments, re-credentialing, and execute new contract applications with commercial and government health plans.
  • Maintain comprehensive knowledge of managed care company and plan requirements to ensure efficient and timely credentialing of providers.
  • Effectively communicate the contracting and enrollment process, addressing client and staff inquiries, and providing regular status updates to internal teams and external stakeholders.
  • Coordinate the credentialing process for healthcare providers with various insurance payers, ensuring compliance with regulatory requirements and internal protocols.
  • Maintain accurate provider records in credentialing databases, updating all relevant information promptly.
  • Respond to inquiries from healthcare providers, payers, and internal departments regarding credentialing status and guidelines.
  • Monitor and ensure the accuracy of credentialing files, flagging and resolving any discrepancies proactively.
  • Stay up-to-date with any Medicaid and Commercial plans guidelines changes.
  • Collaborate with Billing Specialists to resolve credentialing issues affecting claim submissions and reimbursements.
  • Maintain professionalism and respect in interactions with all internal and external stakeholders, fostering a positive and collaborative working environment.

Requirements:

  • High School Diploma (or GED).
  • Minimum 3 years of experience in physician credentialing or health insurance credentialing.
  • Familiarity with the insurance enrollment process for various payers, including Medicare, Medicaid, and private insurers.
  • Strong project management abilities, with the capacity to manage multiple applications and collaborate with payers to meet deadlines.
  • Excellent attention to detail and organizational skills.
  • Exceptional verbal and written communication skills.
  • Knowledge of federal, state, and local legal and regulatory provisions related to credentialing.
  • Proficiency in CPT/HCPCS/ICD-9/ICD-10.
  • EMR/RT knowledge preferred but not required.
  • Certified Provider Credentialing Specialist (CPCS) certification preferred but not required.

Physical Demands:

The physical demands of this remote position primarily involve extended periods of sitting and working at a computer. This role may require the employee to:

  • Sit or stand at a desk for prolonged periods, often between 6–8 hours per day.
  • Frequently use standard office equipment, such as a computer, keyboard, mouse, and telephone.
  • Occasionally lift and carry items weighing up to 10 pounds.
  • Maintain focus on a computer screen and handle repetitive movements such as typing and mouse usage.
  • Participate in virtual meetings, requiring active listening and effective communication.

Company Values:

NAPA Center is committed to the following core values:

  • Love – We strive to infuse kindness and care into our actions and words, creating a supportive community built upon love.
  • Hope – We believe in the potential of every child and are committed to offering unwavering support to our families, guiding them toward success, and inspiring hope.
  • Share – We strive toward progress and connection through continuous collaboration among team members, as well as with our clients and their families.
  • Grow – We are committed to providing the most advanced and effective therapy, ensuring the continual improvement of our services.

  • Credentialing Coordinator

    1 week ago

    Los Angeles, California, United States RadNet Los Angeles Full time

    About the RoleWe are seeking a highly skilled and detail-oriented Credentialing Coordinator to join our team at RadNet Los Angeles. As a Credentialing Coordinator, you will play a critical role in ensuring the accuracy and completeness of radiologist credentials, facilitating the credentialing process, and maintaining compliance with regulatory...

  • Credentialing Coordinator

    7 days ago

    Los Angeles, California, United States RadNet Full time

    Job OverviewRadNet is seeking a highly skilled Credentialing Coordinator to join our team. As a Credentialing Coordinator, you will play a critical role in ensuring the accuracy and completeness of radiologist credentials, facilitating the credentialing process, and maintaining compliance with regulatory requirements.Key ResponsibilitiesAssist with the...

  • Credentialing Coordinator

    1 week ago

    Los Angeles, California, United States PROVIDENCE, INC. Full time

    Job SummaryThe Continuing Medical Education (CME) Coordinator is responsible for developing educational programs for the medical staff to ensure compliance with regulatory agencies. This role requires strong organizational and communication skills to coordinate with medical staff and other stakeholders.Key ResponsibilitiesDevelop and implement educational...

  • Credentialing Specialist

    3 weeks ago

    Los Angeles, California, United States Nexus Hr Full time

    Credentialing Specialist Job DescriptionNexus HR is seeking a skilled Credentialing Specialist to oversee and manage the credentialing processes for healthcare professionals within our organization.About the JobThe ideal candidate will be responsible for ensuring the compliance of medical providers with legal regulations and accreditation standards. They...

  • Credentialing Specialist

    6 days ago

    Los Angeles, California, United States Metis Practice Solutions Full time

    Job Title: Credentialing SpecialistMetis Practice Solutions is seeking a highly organized and detail-oriented Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in ensuring that healthcare providers in private practices are properly credentialed and comply with all payer and licensing regulations.Key...

  • Credentialing Specialist

    3 weeks ago

    Los Angeles, California, United States RadNet Full time

    Credentialing Coordinator Role at RadNetWe are seeking a highly organized and detail-oriented Credentialing Coordinator to join our team at RadNet. As a Credentialing Coordinator, you will play a critical role in ensuring the accuracy and completeness of radiologist credentials, facilitating a seamless experience for our patients and providers.Key...

  • Credentialing Specialist

    1 week ago

    Los Angeles, California, United States JWCH Institute Full time

    Job Title: Credentialing CoordinatorJob Summary:The Credentialing Coordinator plays a vital role in ensuring the accuracy and completeness of healthcare practitioner credentials within our organization. This position is responsible for coordinating the credentialing process, maintaining accurate records, and ensuring compliance with regulatory...

  • Credentialing Specialist

    1 week ago

    Los Angeles, California, United States MedPOINT Management Full time

    Job SummaryWe are seeking a highly skilled Credentialing Coordinator to join our team at MedPOINT Management. The successful candidate will be responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process for our providers.Key ResponsibilitiesCollaborate with CVO, credentialing staff, and provider services to ensure...

  • Insurance Sales Representative

    7 days ago

    Los Angeles, California, United States Combined Insurance Full time

    Agency Coordinator Job DescriptionAt Combined Insurance, we are seeking a highly motivated and results-driven Agency Coordinator to join our team. As an Agency Coordinator, you will play a critical role in driving sales growth and supporting the delivery of sales objectives for our assigned area.Key Responsibilities:Generate new customers and sales through...

  • Radiology Credentialing Specialist

    3 weeks ago

    Los Angeles, California, United States RadNet Full time

    Job Title: Radiology Credentialing SpecialistAt RadNet, we are committed to delivering exceptional patient care and advancing the field of radiology. As a Radiology Credentialing Specialist, you will play a critical role in ensuring the accuracy and efficiency of our credentialing processes.Responsibilities:Assist with the collection and verification of...

  • Insurance Sales Representative

    7 days ago

    Los Angeles, California, United States Combined Insurance Full time

    Job Title: Agency CoordinatorAs an Agency Coordinator at Combined Insurance, you will play a crucial role in driving sales growth and supporting the delivery of sales objectives within a specific geographic area.Key Responsibilities:Prospect new customers independently and meet with current customers to sell Insurance products.Support the identification and...

  • Credentialing and Compliance Specialist

    3 weeks ago

    Los Angeles, California, United States Planned Parenthood Los Angeles Full time

    About the RolePlanned Parenthood Los Angeles is seeking an experienced Credentialing and Compliance Specialist to join our team in Downtown Los Angeles. As a key member of our organization, you will play a critical role in ensuring the credentialing and re-credentialing process is executed efficiently and effectively.Key ResponsibilitiesLead, coordinate, and...

  • Radiology Credentialing Specialist

    7 days ago

    Los Angeles, California, United States RadNet Full time

    Job Title: Radiology Credentialing SpecialistAt RadNet, we are committed to delivering quality, value, and access in the 21st century. We are seeking a highly skilled Radiology Credentialing Specialist to join our team of professionals who are dedicated to achieving the best clinical outcomes.Responsibilities:Assist with the gathering of information required...

  • Insurance Broker

    2 weeks ago

    Los Angeles, California, United States Alliant Insurance Services Full time

    Job Title: Account Executive - Real EstateAt Alliant Insurance Services, we are seeking a highly skilled and experienced Account Executive to join our team. As an Account Executive, you will be responsible for managing and directing a portfolio of clients, providing exceptional customer service, and driving business growth.Key Responsibilities:Manage and...

  • Insurance Investigator

    3 weeks ago

    Los Angeles, California, United States Department of Insurance Full time

    Job Description and DutiesJob Summary: We are seeking a highly skilled and experienced Special Investigator to join our team at the Department of Insurance. As a Special Investigator, you will be responsible for conducting investigations related to regulatory compliance and/or criminal investigations, including the enforcement of California and Federal laws...

  • Insurance Account Manager

    2 weeks ago

    Los Angeles, California, United States Heffernan Insurance Brokers Full time

    Account Executive Job DescriptionHeffernan Insurance Brokers is seeking an experienced Commercial Lines Account Executive to join its Southern California team. This role combines sales and account management responsibilities, requiring a dynamic individual to lead client relationships and develop innovative strategies for risk management and insurance...

  • Commercial Insurance Account Executive

    1 month ago

    Los Angeles, California, United States Heffernan Insurance Brokers Full time

    Objective: Heffernan Insurance Brokers is seeking a skilled Account Manager to become a vital part of its Commercial Lines division. This position offers a dynamic opportunity to implement innovative strategies tailored to meet clients' insurance and risk management requirements. Key Responsibilities: Manage marketing efforts and account oversight...

  • Pediatric Insurance Specialist

    3 weeks ago

    Los Angeles, California, United States Children's Hospital Los Angeles Full time

    OverviewChildren's Hospital Los Angeles (CHLA) is a leader in pediatric and adolescent health, providing world-class care to children in California. As a Magnet teaching hospital, we offer a dynamic environment that fosters learning, care, and compassion.Job SummaryThe Insurance Verification Representative plays a critical role in ensuring that all...

  • Producer/Broker - Wholesale Insurance Specialist

    2 weeks ago

    Los Angeles, California, United States USG Insurance Services, Inc. Full time

    Job SummaryUSG Insurance Services, Inc. is seeking a highly motivated and experienced Producer/Broker to join our team. As a key member of our sales team, you will be responsible for soliciting, underwriting, marketing, and securing coverage for our business enterprises within the excess and surplus lines marketplace.Key ResponsibilitiesDevelop and maintain...

  • Credentialed Special Education Professional

    1 month ago

    Los Angeles, California, United States Total Education Solutions Full time

    Job SummaryTotal Education Solutions is seeking a highly skilled and dedicated Credentialed Special Education Teacher to join our team. As a key member of our Specialized Academic Instruction team, you will play a vital role in supporting schools across the Los Angeles area.Key ResponsibilitiesOversee and execute school's Individualized Education Program...