Top 6 Credentialing specialist Jobs in Upland, Ca

Credentialing Specialist
Western University of Health Sciences —Pomona, CA
- $25 - $28 an hour
- Full-time
- Background check
- Microsoft Outlook
- Word processing
- Paid time off
- Retirement plan
Credentialing Specialist
Akido —Chino, CA
- $24 - $33 an hour
- Full-time
- Mid-level
- Office
- 3 years
- Health insurance
- Dental insurance
Quick Apply
Credentialing and Provider Enrollment Specialist
Chaparral Medical Group —Chino, CA
- $47,800 - $66,650 a year
- Mid-level
- Office
- 3 years
- Dental insurance
- Vision insurance
Quick Apply

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CREDENTIALING SPECIALIST
Los Angeles County Department of Human Resources —Los Angeles County, CA
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Provider Enrollment & Credentialing Subject Matter Expert (SME)
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Credentialing Specialist

Western University of Health Sciences -
Pomona, CA

Apply Now

Job Details

Full-time
$25 - $28 an hour

Benefits

Paid time off
Retirement plan

Qualifications

Customer communication
Microsoft Outlook
Accreditation standards (regulatory compliance area)
Word processing
Windows
State healthcare regulations
High school diploma or GED
SharePoint

Full Job Description

Provides integral support to healthcare operations by enabling timely onboarding of healthcare providers through the evaluation, analysis, and coordination all aspects of the credentialing and recredentialing processes for practitioners practicing within the WesternU Health System clinical entities.

Knowledge, Skills and Abilities

Individuals must possess the knowledge, as well as the following skills and abilities or be able to perform the essential functions of the job, with or without reasonable accommodation using some other combination of skills and abilities.

Strong working knowledge of healthcare provider credentialing process
Experience working with Windows based applications: Excel, Word, Outlook, SharePoint
Significant knowledge of State and Federal Regulatory requirements and accreditation standards, e.g., NCQA, NPDB, Title XXII, CAQH and NPPES related to healthcare provider credentialing
Considerable working knowledge of credentialing management applications, e.g., Verity Stream
Strong customer focus, interpersonal, collaboration, written/verbal communication, prioritization, and computer skills
Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process.
Demonstrated attention to detail and good organizational capability.
Able to handle multiple simultaneous tasks and complete work projects in designed time frames.
Demonstrate a commitment to working in an organization that values and promotes humanism.

Required Qualifications

Any combination of education, training and experience that provides the required knowledge, skills, and abilities.

Education: High School Diploma or equivalent.
Experience: Minimum of two years of relevant experience in provider credentialing.

Preferred Qualifications

Preference will be given to individuals with NAMSS Certification as Certified Provider Credentialing Specialist (CPCS) certification.

Experience: A background in clinical academic setting is highly preferred.

Essential Job Duties

Key Responsibilities

Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards.

Key Responsibilities

Prepares documents for primary source verification process, collects, and validates documents to ensure accuracy of all credentialing elements.
Assesses completeness of information and qualifications relative to credentialing standards and WesternU Health System criteria.

Key Responsibilities

Identifies, analyzes, and resolves extraordinary information, discrepancies, time gaps and other peculiarities that could adversely impact ability to credential and enroll practitioners.
Discovers and conveys problems to Executive Director University Compliance and Chair of Provider Credentialing Committee for sound decision making in accordance with credentialing policies and procedures, federal, state, local and government/insurance agency regulations.

Key Responsibilities

Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies.
Prepares and provides information to internal and external customers as appropriate.

Key Responsibilities

Enters, updates, and maintains data from provider applications into credentialing database, focusing on accuracy, and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.

Key Responsibilities

Submits and responds to requests for required documentation to third-party payors for credentialing/recredentialing.

Key Responsibilities

Prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines.

Key Responsibilities

Participates in the development and implementation of process improvements for the system-wide credentialing process,
Prepares reports and scoring required by regulatory and accrediting agencies, policies, and standards.

Key Responsibilities

Communicates clearly with providers, their liaisons, Clinical Deans and WesternU Health Administration, as needed to provide timely responses upon request on day-to-day credentialing and privileging issues as they arise.

Key Responsibilities

Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest developments to enhance understanding of various regulations and legislation of the health care industry.

Key Responsibilities

Performs miscellaneous job-related duties as assigned.

Posting Details Continued

Work Schedule

Monday-Friday, 8 AM -5 PM.

Working at WesternU

We believe in making an impact in the lives of our employees, personally, and professionally. Every employee has different individual and/or family needs. We offer benefits that are both comprehensive and flexible to address your unique needs. We believe work-life harmony is positive and achievable.

We offer competitive salaries, generous paid time off, insurance plans, reimbursements, and retirement benefits. Additionally,

Our faculty, staff, and administrators are 100% focused on student success.

Our University culture creates the context for a nurturing and supportive environment.

Faculty, staff, and students can expect to make deep, personal relationships within the University community.

As a Faculty, Staff, or Student at WesternU, you can focus on work that you love, be your authentic self, and lead to the future with innovation in health sciences.

WesternU’s core value of humanism encourages all to bring their whole self in all that they do.

We are committed to fostering a culture of respect, equity, collaboration, and fun at all levels for all people!

Expected Pay Scale

Minimum

$25.00 Hourly

Maximum

$28.00 Hourly

Physical Demands

Do the essential functions of this job require lifting?

Yes

If yes, list maximum weight and duration

The physical demands described here are representative of those that must be met by any employee to successfully perform the essential functions of this job. Reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is frequently required to use hands, reach with hands and arms, and stoop. The employee is regularly required to stand, walk, and carry up to 25 pounds.

Describe Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Duties are normally performed in a typical office setting. Occasionally the employee is exposed to outdoor weather and road conditions. The noise level in this setting is usually low to moderate.

Posting Information

Posting Number

S01709

Posting Date

10/15/2025

Close Date

10/15/2026

Open Until Filled

Yes

Conditions of Employment - Background Check

To secure employment, successful fulfillment of a background check, including a criminal records check, may be required. Western University of Health Sciences will extend a conditional offer of employment, subject to rescission if the background check unveils disqualifying information or if it is found that the candidate deliberately withheld or misrepresented information. Non-completion of the background check to satisfaction may impact the ongoing employment of a current Western University of Health Sciences employee who received a conditional offer for the position.

Pay Transparency Act

Pay Transparency Act- Western University of Health Sciences is required to provide a reasonable estimate of the compensation range for this role. This range considers various factors in making compensation decisions, including but not limited to experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. It is not typical for an individual to be offered a salary at or near the top of the range for a position. Salary offers are determined based on final candidate qualifications and experience. The Expected Pay Scale is defined as the budgeted salary or hourly range that the University reasonably expects to pay for this position. Placement within the Expected Pay Scale is determined by internal equity and relevant qualifications.

Equal Opportunity Statement (EEO)

It is the policy of Western University to provide equal employment opportunity to all employees and applicants for employment as required by law without regard to age, race, color, national origin ancestry, citizenship, ethnicity, creed, religion or religious creed, sex or gender (including gender identity), marital status, sexual orientation, disability (both physical and mental) including HIV and AIDS, medical condition (cancer and genetic characteristics), pregnancy (which includes childbirth, breastfeeding and medical conditions related to pregnancy, childbirth or breastfeeding), age, genetic information, military and veteran status, or any other applicable protected characteristic as outlined by federal, state, or local laws.This policy applies to all employment practices within WesternU including without limitation, hiring, recruiting, promotion, termination, layoffs, leave of absence, compensation, benefits, and training. WesternU makes hiring decisions based solely on qualifications, merits, and business needs at the time.

Applicant Documents

Required Documents

Resume

Optional Documents

Cover Letter

Letter of Recommendation #1

Letter of Recommendation #2

Letter of Recommendation #3

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credentialing specialist jobs in upland, ca

Credentialing Specialist

Credentialing Specialist

Credentialing and Provider Enrollment Specialist

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