Credentialing Specialist

Pc Cfl; Orlando (FL); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Competitive compensation

Medical, dental and vision insurance

Life insurance

PTO

Holiday pay

Bonus structure

401K with company match

Job summary

Home Physicians Group seeks a Credentialing Specialist to join our growing team in Central Florida. You will coordinate provider credentialing, recredentialing, and payer enrollment to ensure regulatory and organizational requirements are met.

This role supports onboarding, maintains credentialing files, and monitors expirations with a focus on accuracy. A strong background in credentialing or healthcare administration is required, with familiarity in CAQH and PECOS preferred.

Qualifications

• Minimum 2 years of credentialing or healthcare administration experience.
• Experience with provider credentialing, payer enrollment, or medical staff services.
• Knowledge of CAQH, PECOS, and insurance payer portals preferred.
• Associate degree or higher preferred for further expertise.

Responsibilities

• Coordinate initial credentialing and recredentialing for physicians and advanced practice providers.
• Complete and maintain provider enrollment with Medicare, Medicaid, and commercial insurance plans.
• Monitor credential expiration dates, licenses, certifications, and malpractice coverage.
• Maintain accurate provider files and credentialing databases.
• Communicate with providers, payers, hospitals, facilities, and regulatory agencies regarding credentialing status.
• Ensure compliance with federal, state, payer, and organizational requirements.
• Assist with onboarding new providers and maintaining provider records.
• Support audits and accreditation activities as needed.

Skills

Organizational skills

Time management

Communication skills

MS Office

Confidentiality

Critical thinking

Teamwork / independence

Education

High school diploma or GED

Associate's or Bachelor's degree preferred

Tools

CAQH

PECOS

Job description

Home Physicians Group is seeking a detail-oriented and organized Credentialing Specialist to join our growing team. If you enjoy working in a fast-paced healthcare environment and have experience managing provider credentialing and enrollment, we'd love to hear from you!

Our company was founded in 2005 and we serve the Central Florida geriatric population across 14 counties.

Our Mission: We create a nurturing healthcare experience, empowering patients by providing a physician led ecosystem based on a foundation of Science, Technology, Faith, and Compassion.

Position Summary

The Credentialing Specialist is responsible for coordinating all aspects of provider credentialing, recredentialing, and payer enrollment to ensure our providers meet all regulatory, payer, and organizational requirements. The ideal candidate will also be responsible for maintaining the facility credentialing applications for providers.

Responsibilities

• Coordinate initial credentialing and recredentialing for physicians and advanced practice providers.
• Complete and maintain provider enrollment with Medicare, Medicaid, and commercial insurance plans.
• Monitor credential expiration dates, licenses, certifications, and malpractice coverage.
• Maintain accurate provider files and credentialing databases.
• Communicate with providers, payers, hospitals, facilities, and regulatory agencies regarding credentialing status.
• Ensure compliance with federal, state, payer, and organizational requirements.
• Assist with onboarding new providers and maintaining provider records.
• Support audits and accreditation activities as needed.

Qualifications

• High school diploma or GED required; Associate's or Bachelor's degree preferred.
• Minimum of 2 years of credentialing or healthcare administration experience preferred.
• Experience with provider credentialing, payer enrollment, or medical staff services.
• Knowledge of CAQH, PECOS, and insurance payer portals preferred.

• Competitive compensation
• Medical, dental and vision insurance available
• Life insurance
• PTO
• Holiday pay
• Bonus structure
• 401K with company match

Skills

• Excellent organizational and time management skills
• Ability to manage multiple deadlines and priorities
• Strong written and verbal communication skills
• Proficiency in Microsoft Office (Excel, Word, Outlook)
• Ability to maintain confidentiality and handle sensitive information
• Critical thinking and problem-solving skills
• Ability to work independently and as part of a team.