Credentialing Specialist jobs in Miami, FL

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Credentialing Specialist
  • Gastromed, LLC
  • Coral, FL FULL_TIME
  • JOB TITLE:       Credentialing Specialist          

    REPORTS TO:  Revenue Cycle Manager 

    FLSA STATUS: Non-Exempt                                                         

    QUALIFICATIONS/EDUCATION: 

    • AA Degree required.

    • Minimum two years of experience in healthcare credentialing.

    • Knowledge of regulatory requirements and accreditation standards for provider credentialing.
    • Proficient in MS Office and intermediate in Excel, Word, and Outlook.
    • Experience in using credentialing software and databases.
    • Strong attention to detail and ability to maintain accurate records.
    • Excellent organizational and time management skills.
    • Effective communication skills, both written and verbal.

    SUPERVISORY RESPONSIBILITIES: 

    N/A 

    ESSENTIAL DUTIES/ RESPONSIBILITIES: 

    • Completes provider applications/reapplications.
    • Responds to requests from insurance companies for information/documentation.
    • Follow up with insurance companies and hospitals regarding the status of physician applications.
    • Notifies insurance carriers when a physician joins or leaves the practice.
    • Tracks the above information to promote the speed of processing.
    • Processes change of addresses for each practitioner/practice location.
    • Manages renewals (medical licenses, DEA's, occupational licenses) for all providers.
    • Maintains Availity, NPI, and CAQH databases and quarterly re-attestation.
    • Obtain Hospital Privileges for providers and re-credentialing.
    • Maintains a current and accurate contract listing, identifying the credentialing status of all physicians for the plan and updating the SharePoint site information.
    • Responds to requests from insurance companies for information/documentation.
    • Conduct primary source verification of credentials and qualifications.
    • Verify and validate provider information, including licensure, certifications, and education.
    • Assists Marketing in identifying all insurance plans by physicians. Updates the Insurance Plans via the FMC internet for each provider.
    • Maintains a resource file on each practitioner electronically, which includes copies of current licenses/CME/ DEA/malpractice/Board certifications/plan participation/ Hospital privilege information.
    • Follow up with insurance companies and hospitals regarding the status of physician applications.
    • Assist in process improvement of the credentialing process.
    • collaborate with internal teams to resolve credentialing issues or discrepancies.
    • Performs other related duties as required and assigned.

     

    Qualified individuals, please submit your resume.

    We offer a competitive salary; Employee Health Insurance is covered at 100%. We also offer Dental, Vision, Life, and 401k Benefits.

  • 1 Month Ago

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Credentialing Specialist
  • Medrina
  • Miami, FL FULL_TIME
  • Join our growing team in Miami, FL, and be a valuable member supporting national healthcare provider with hundreds of sites across U.S.! The Credentialing Specialist is responsible for credentialing o...
  • 1 Month Ago

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Healthcare Credentialing Specialist
  • Pinnacle Wound Management
  • Miami, FL FULL_TIME
  • Pinnacle Wound Management is looking for an experienced Healthcare Credentialing Specialist to join our team. Pinnacle Wound Management and its national network of affiliated wound care specialist pro...
  • 14 Days Ago

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Manage services organization credentialing and contracting specialist - Now Hiring
  • Eastern Medical Center Corp
  • Miami, FL FULL_TIME
  • Job Description Assists in the identification of service level gaps and works with Manager of Provider Relations and Contract Managers to address recruitment opportunitiesWorks with providers and netw...
  • 1 Day Ago

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Shipping and Receiving
  • Specialist ID
  • Doral, FL FULL_TIME
  • the Position Information: We're Hiring: Full-Time Warehouse and Production Position - Grow with Specialist ID! Eager to be part of a dynamic and caring team? Specialist ID is on the hunt for a motivat...
  • 12 Days Ago

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Digital Printing Team Leader/Manager
  • Specialist ID
  • Doral, FL FULL_TIME
  • About us Specialist ID is a leading e-commerce company based in Miami, FL, committed to excellence and innovation in the field of identification products and accessories. Our commitment to Care, Owner...
  • 12 Days Ago

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0 Credentialing Specialist jobs found in Miami, FL area

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Credentialing Manager
  • DOCTORS HEALTHCARE PLANS, INC.
  • Miami, FL
  • Scope of Position: Manages staff that process credentialing and recredentialing applications for medical providers and p...
  • 3/28/2024 12:00:00 AM

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Senior Planner, Brownfields Redevelopment
  • Stantec
  • Miami, FL
  • Senior Planner, Brownfields Redevelopment - ( 240000KH ) Description Strong communities don't just happen-they're built....
  • 3/28/2024 12:00:00 AM

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Payer Relations Credentialing and Contract Support Specialist
  • VITAS Healthcare
  • Hollywood, FL
  • Job Description Payer Relations Credentialing and Contract Support is responsible for prioritizing and cataloguing all i...
  • 3/28/2024 12:00:00 AM

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Remote Resort Specialist
  • Travel Travel Yes
  • Miami, FL
  • Remote Resort Specialist - Turn Your Love for Travel into a Rewarding Career About Us: Join our team of Remote Resort Sp...
  • 3/28/2024 12:00:00 AM

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Remote Resort Specialist
  • Careerbuilder
  • Miami, FL
  • Remote Resort Specialist - Turn Your Love for Travel into a Rewarding Career About Us: Join our team of Remote Resort Sp...
  • 3/27/2024 12:00:00 AM

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Provider Engagement Specialist
  • Little Havana Activities and Nutrition Centers of Dade County
  • Miami, FL
  • Job Description Job Description Position Description: 1. Acts as a liaison between claims and credentialing departments....
  • 3/27/2024 12:00:00 AM

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Patient Experience Specialist
  • Mount Sinai Medical Center of Miami Beach
  • Miami Beach, FL
  • Administrative Assistant - Performance Improvement As Mount Sinai grows, so does our legacy in high-quality health care....
  • 3/25/2024 12:00:00 AM

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Credentialing Specialist
  • Green Key Resources
  • Miami, FL
  • ***This position has potential for remote/hybrid with training on site in 33183 ***Direct Hire Opening*** Pay:(flex depe...
  • 3/24/2024 12:00:00 AM

Miami, officially the City of Miami, is the cultural, economic and financial center of South Florida. Miami is the seat of Miami-Dade County, the most populous county in Florida. The city covers an area of about 56.6 square miles (147 km2), between the Everglades to the west and Biscayne Bay on the east; with a 2017 estimated population of 463,347, Miami is the sixth most densely populated major city in the United States. The Miami metropolitan area is home to 6.1 million people and the seventh-largest metropolitan area in the nation. Miami's metro area is the second-most populous metropolis i...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Credentialing Specialist jobs
$39,909 to $50,537
Miami, Florida area prices
were up 2.9% from a year ago

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