Medical Staff Credentialing Specialist, Sr. jobs in Miami, FL

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 our medical providers and processing physician credentialing applications to ensure compliance and completeness of licenses and agreements with various agencies and private health insurance plans. 

This is a full-time position with a Monday – Friday work schedule.  This position operates out of our Miami, FL office. We offer an excellent benefits package with immediate health and dental insurance, 401k plan with a company match, 15 days of paid vacation, and holiday, sick pay and much more.   

 
Duties/Responsibilities: 

• Responsible for credentialing and recredentialing of medical providers with the company, state and federal agencies, and private health insurance plans. 
• Performs primary source verification for initial credentialing and recredentialing. 
• Maintains credentialing and provider enrollment database and files, including supporting documentation. 
• Works closely with clinical staff to obtain data, documents, and signatures, as needed, in a timely and secure manner. 
• Tracks and performs follow through with insurance plans until provider enrollment is complete and provider is in-network with the plan. 
• Troubleshoots provider issues related to enrollment and insurance plan credentialing. 
• Uses credentialing and provider enrollment software and other computer programs, as applicable, effectively. 
• Tracks expirable and updates documentation in a timely manner. 
• Remains current on all regulatory changes in the acute and post-acute care environment.   
• Performs other duties and responsibilities as required, assigned, or requested. 

Requirements: 

• High School Diploma and an associate’s degree in health services administration or related field. 
• Certified Provider Credentialing Specialist (CPCS) certification or Certified Credentialing Specialist (CCS) certification. 
• Minimum 3 years of experience in credentialing physicians for hospitals and enrolling physicians with health plans.   
• Experience and proficiency with general computer software (Word, Excel, PowerPoint, PDF, Outlook, credentialing software) 
• Ability to maintain effective interpersonal relationships. 
• Ability to communicate effectively in both oral and written form with physicians and external partners. 
• Skilled in completing assignments accurately and with attention to detail. 
• Ability to independently plan, organize and prioritize work. 

Travel and Physical Requirements: 

• Very occasional travel out of Miami area.
• Prolonged periods of sitting at a desk. 
• Must be able to lift up to 15 pounds at times. 

EOE/M/F/Vet/Disability 

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by law.