Credentialing Specialist

Deutsche Structured Finance Gmbh; Miami (FL); On-site; USD 24,796 - 34,440; Full time

Benefits offered by this job

Medical insurance

Dental & Vision

Aflac

Retirement plan options

Paid Time Off (PTO)

Professional development opportunities

Job summary

Nova Medical Services is seeking an experienced Credentialing Specialist to join our Kendall office. This role manages the credentialing and recredentialing process for healthcare providers while ensuring compliance with federal, state, payer, and accreditation requirements.

The ideal candidate is bilingual in English and Spanish and has a strong understanding of healthcare insurance plans and credentialing procedures.

Qualifications

• 2–4 years of credentialing experience in healthcare
• Bilingual in English and Spanish (written and verbal)
• Strong knowledge of provider credentialing and payer requirements
• Proficient in Microsoft Office and credentialing software

Responsibilities

• Process provider credentialing and recredentialing applications accurately and efficiently.
• Verify provider qualifications, licenses, certifications, malpractice coverage, and other required documentation.
• Maintain compliance with federal, state, payer, and accreditation guidelines.
• Coordinate with insurance carriers, healthcare organizations, and providers regarding credentialing status.
• Maintain electronic credentialing records and ensure documentation is current.
• Monitor credential expiration dates and proactively manage renewals.
• Research and resolve credentialing discrepancies in a timely manner.
• Communicate regularly with providers and internal departments regarding credentialing updates.
• Prioritize multiple projects while meeting strict deadlines.

Skills

Bilingual English and Spanish

Attention to detail

Time management

Communication skills

Tools

Credentialing software

Microsoft Office

Job description

Nova Medical Services is seeking an experienced and detail-oriented Credentialing Specialist to join our team in our Kendall office. If you have a passion for healthcare administration, thrive in a fast-paced environment, and have extensive experience managing provider credentialing, we'd love to hear from you!

Join Our Growing Healthcare Team!

Position Summary

The Credentialing Specialist will be responsible for managing the credentialing and recredentialing process for healthcare providers while ensuring compliance with federal, state, payer, and accreditation requirements. The ideal candidate is highly organized, bilingual in English and Spanish, and has a strong understanding of healthcare insurance plans and credentialing procedures.

Key Responsibilities

• Process provider credentialing and recredentialing applications accurately and efficiently.
• Verify provider qualifications, licenses, certifications, malpractice coverage, and other required documentation.
• Maintain compliance with federal, state, payer, and accreditation guidelines.
• Coordinate with insurance carriers, healthcare organizations, and providers regarding credentialing status.
• Maintain accurate electronic credentialing records and ensure documentation is current.
• Monitor credential expiration dates and proactively manage renewals.
• Research and resolve credentialing discrepancies in a timely manner.
• Communicate regularly with providers and internal departments regarding credentialing updates.
• Prioritize multiple projects while meeting strict deadlines.

Qualifications

• 2–4 years of credentialing experience in a medical or healthcare setting required.
• Bilingual in English and Spanish (written and verbal).
• Strong knowledge of provider credentialing, enrollment, healthcare insurance plans, and payer requirements.
• Exceptional attention to detail and organizational skills.
• Excellent time management and ability to manage multiple priorities.
• Proficient in Microsoft Office (Word, Excel, Outlook) and credentialing software.
• Strong communication and interpersonal skills.

Preferred Qualifications

• Knowledge of medical terminology and healthcare regulations.

Compensation & Benefits

• Starting Pay: $18-25.00 per hour depending on experience!
• Comprehensive benefits package, including:
  • Medical insurance
  • Dental & Vision
  • Aflac
  • Retirement plan options
  • Paid Time Off (PTO)
  • Professional development opportunities

Why Join Nova Medical Services?

At Nova Medical Services, we are committed to delivering exceptional patient care by supporting our providers with efficient and compliant credentialing processes. We value teamwork, accountability, professional growth, and creating a positive workplace culture.

This description indicates, in general terms, the type and level of work performed and responsibilities held by the team member(s). Duties described are not to be interpreted as being all-inclusive or specific to any individual team member.

Our company is committed to creating a diverse environment. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status. DFWP