We are looking for a detail-oriented, proactive Medical Credentialing Specialist for a contract-to-hire role. This position is the perfect opportunity to showcase your expertise, integrate with our tight-knit team, and transition into a permanent role with excellent long-term growth potential and benefits. What We’re Looking For:
- 2–3 years of direct experience in medical credentialing and provider enrollment (experience with both commercial and government payers is highly preferred).
- A solid understanding of NCQA and Joint Commission credentialing guidelines.
- Familiarity with CAQH, PECOS, and various state Medicaid portals.
- Exceptional attention to detail, organizational skills, and the ability to juggle multiple provider files without dropping the ball.
- Comfort picking up the phone to track down network representatives or resolve complex claim denials.
salary: $21 - $24 per hour
shift: First
work hours: 8 AM - 5 PM
education: High School
Responsibilities
- Provider Enrollment: Manage the end-to-end enrollment process for providers with Medicare, Medicaid, and commercial insurance payers.
- Primary Source Verification: Verify provider credentials including medical licenses, DEA certifications, board certifications, and educational background.
- Contracting Support: Coordinate with insurance networks to initiate and track the status of participating provider agreements.
- Data Maintenance: Track expiration dates for licenses and certifications to ensure zero lapses in coverage.
- Issue Resolution: Troubleshoot enrollment-related claim denials and communicate with payers to resolve credentialing discrepancies.
- Compliance: Ensure all provider files meet NCQA (National Committee for Quality Assurance) and Joint Commission standards.
Skills
Qualifications
Randstad is a world leader in matching great people with great companies. Our experienced agents will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temporary-to-permanent or permanent opportunities, no one works harder for you than Randstad.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Randstad, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact HRsupport@randstadusa.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Randstad offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
This posting is open for thirty (30) days.
