Credentialing & Enrollment Specialist

Medusind Inc,; Miami (FL); On-site; USD 42,000 - 62,000; Full time

Job summary

Medusind Inc. seeks a Credentialing & Enrollment Representative to evaluate, analyze, and coordinate all aspects of credentialing and recredentialing for medical, dental, optometry, and behavioral health providers and clinics with health plans nationwide.

You will enroll with plans, manage data, and ensure CAQH updates on a quarterly basis. The role requires a Bachelor’s degree and at least 2 years of credentialing experience, with strong knowledge of Medicare, Medi-Cal, Managed Care and

Qualifications

• Bachelor’s degree preferred.
• Minimum of 2 years of full-time credentialing experience across providers and clinics.
• Experience with Medicare, Medi-Cal, Managed Care and Commercial insurances is required.

Responsibilities

• Enroll with health plans and submit enrollment to payors in a timely manner.
• Maintain enrollment data and follow-ups with health plans.
• Verify provider demographics and NPPES data are up to date.
• Prepare verifications and support high-volume provider applications.
• Communicate with providers, liaisons, and client teams to resolve issues.
• Monitor files for completeness and quality against accreditation standards.

Skills

Communication & collaboration

Detail-oriented

Regulatory compliance knowledge

Education

Bachelor’s degree in Healthcare Administration, Business, Finance or related field

Tools

CAQH

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

Medusind Inc. seeks a Credentialing & Enrollment Representative to evaluate, analyze, and coordinate all aspects of credentialing and recredentialing for medical, dental, optometry, and behavioral health providers and clinics with health plans nationwide.

You will enroll with plans, manage data, and ensure CAQH updates on a quarterly basis. The role requires a Bachelor’s degree and at least 2 years of credentialing experience, with strong knowledge of Medicare, Medi-Cal, Managed Care and