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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®

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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.

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