Lead Medical Credentialing Specialist

Virtual Latinos is looking for a Full-Time Lead Medical Credentialing Specialist to support a well-established dermatology medical office in California.
This medical practice specializes in skin cancer treatment, general dermatology, cosmetic dermatology, and teledermatology. The ideal candidate has hands-on experience managing credentialing, re-credentialing, and payer contracting for California providers, including Medicare, Medicaid, and commercial payers. This role will also oversee the credentialing department, delegate tasks, track approvals and renewals, and report on team performance. The ideal candidate is highly organized, detail-oriented, proactive, and experienced in leading and supporting a credentialing team.
Compensation & Details
Hourly Rate: $14 - $17 USD
💡 This is a full-time, hourly position paid biweekly through Virtual Latinos.
Schedule:
Monday - Friday, 8:00 am - 5:30 pm PST, with a 1-hr lunch break. Occasional Saturday availability may be required as needed to stay on top of workload and deadlines.
Job Summary
The client is seeking an experienced Lead Medical Credentialing Specialist to oversee the end-to-end credentialing, re-credentialing, and contracting processes for California-based providers across multiple specialties. The VA will manage payer applications, maintain compliance documentation, track approvals and renewals, and coordinate with providers and internal teams to resolve credentialing issues. The VA will also manage the department, supervise the team, delegate tasks, and report on department performance and KPIs to leadership. The ideal candidate has hands-on experience credentialing California providers with Medicare, Medicaid, and commercial payers, is highly organized and detail-oriented, and can independently manage multiple priorities while providing effective leadership, training, and support to the credentialing team.
🔧 Key Responsibilities
Manage end-to-end credentialing and re-credentialing for California providers with Medicare, Medicaid, and commercial insurance plans.
Submit, monitor, and follow up on credentialing applications through CAQH, PECOS, PAVE, Availity, and payer-specific portals.
Maintain accurate provider records, including licenses, certifications, professional liability insurance, and other required credentials.
Track application statuses, approvals, expirations, and renewals to ensure timely credentialing and continuous compliance.
Coordinate with providers and internal teams to collect required documentation and resolve credentialing or contracting issues.
Support payer contracting and provider network agreements, including reviewing requirements and assisting with rate negotiations.
Maintain organized digital files, databases, reports, and department KPIs, ensuring accurate, up-to-date documentation.
Lead and support the credentialing team by training team members, delegating tasks, monitoring workload, and participating in weekly leadership and operational meetings.
Requirements:
Proven experience credentialing California-based providers with Medicare, Medicaid, and commercial payers.
Strong knowledge of federal, California state, and payer-specific credentialing requirements.
Experience supporting multispecialty practices and familiarity with payer contracting, or the ability to independently learn and manage these processes quickly.
Comfortable working with Google Workspace and maintaining accurate digital records and KPI reports.
Fluent, professional English (written and verbal) — must be confident and effective on the phone with lawyers, paralegals, and other legal professionals
Comfortable attending weekly leadership and operational meetings.
Experience managing a department, supervising a team, delegating tasks, and reporting progress and KPIs to leadership.
Strong leadership and problem-solving skills, with the ability to independently manage and organize the department, evaluate team performance, and implement improvements as needed.
Strong administrative and organizational background, with the ability to manage departmental operations, priorities, and processes independently.
Confident communication and reporting skills, with the ability to present updates, discuss performance, and actively participate in leadership meetings.
Spanish speakers are highly preferred.
Systems & Tools:
Google Workspace (Docs, Sheets)
Avilaty
PECOS, CAQH, PAVE, and other payer-specific portals
They will need their own VPN (Any VPN)
RingCentral for Calls and transitioning to a new VoIP
Google Meet for Meetings

Work arrangement
No