Credentialing Specialist

Florida Advanced Spine and Orthopedics; Odessa (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

Florida Advanced Spine and Orthopedics is seeking a Credentialing Specialist for a private orthopedic surgeon’s office. The role ensures physicians and APPs are credentialed, enrolled with insurers, and maintain hospital privileges to support billing and compliance.

Ideal candidates have 1–3 years in provider credentialing, familiarity with Medicare/commercial enrollment, and strong organization, communication, and attention to detail.

Qualifications

• Education as listed; credentials and licenses as applicable.
• 1–3 years of provider credentialing experience in a medical practice.
• Knowledge of Medicare and commercial payer enrollment.
• Experience with orthopedic or multispecialty practices is a plus.

Responsibilities

• Complete initial credentialing and recredentialing applications.
• Enroll providers with insurance companies and track expirations.
• Monitor licenses, DEA, board certification, and malpractice dates.
• Communicate with physicians, hospitals, and payers; resolve issues.

Skills

Attention to detail

Organizational skills

Communication

Follow-up skills

Education

High school diploma or GED

Associate or bachelor's degree in healthcare administration, business, or related field

Tools

Microsoft Excel

Microsoft Word

Outlook

Electronic credentialing systems

Job description

A Credentialing Specialist in a private orthopedic surgeon’s office is responsible for ensuring physicians and advanced practice providers (physician assistants and nurse practitioners) are properly credentialed, enrolled with insurance companies, and maintain hospital privileges so the practice can bill for services and remain compliant.

Typical requirements include:

Education

• High school diploma or GED (minimum)
• Associate or bachelor’s degree in healthcare administration, business, or a related field is often preferred.

Experience

• 1–3 years of provider credentialing experience in a physician practice, hospital, or healthcare organization
• Experience with orthopedic, surgical, or multispecialty practices is a plus
• Knowledge of provider enrollment for Medicare, and commercial insurance plans.

Knowledge & Skills

• NPI registration
• Hospital privileging and recredentialing
• Primary source verification
• Knowledge of CMS, Joint Commission, NCQA, and payer requirements
• Familiarity with provider contracts and malpractice documentation
• Excellent organization and attention to detail
• Strong communication and follow-up skills
• Proficiency in Microsoft Excel, Word, Outlook, and electronic credentialing systems.

Preferred Certifications

While not always required, many employers prefer:

• CPCS (Certified Provider Credentialing Specialist) through NAMSS
• CPMSM (Certified Professional Medical Services Management) for more senior roles.

Common Daily Responsibilities

• Complete initial credentialing and recredentialing applications
• Enroll providers with insurance companies
• Track license, DEA, board certification, and malpractice expiration dates
• Communicate with physicians, hospitals, and insurance payers
• Resolve credentialing issues that delay provider participation or reimbursement.

This role is ideal for someone who is highly organized, enjoys administrative work, and can manage multiple deadlines while maintaining accuracy and confidentiality. In a private orthopedic office, knowledge of surgical credentialing and hospital privileging is especially valuable because orthopedic surgeons typically operate at one or more hospitals or ambulatory surgery centers.