Credentialing Specialist Credentialing Specialist

HOME PHYSICIANS GROUP; Orlando (FL); On-site; USD 52,000 - 64,000; Full time

Job summary

Home Physicians Group seeks a Credentialing Specialist to coordinate all aspects of provider credentialing, recredentialing, and payer enrollment in a fast-paced healthcare setting. The role includes maintaining credentialing databases and ensuring regulatory compliance.

Ideal candidates will have at least 2 years of credentialing or healthcare administration experience, with a high school diploma or GED; Associate's or Bachelor's degree preferred. Orlando area advantage, on-site position.

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.

Responsibilities

• Coordinate initial credentialing and recredentialing for physicians and advanced practice providers.
• Complete and maintain provider enrollment with Medicare, Medicaid, and commercial insurance plans.
• 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.

Skills

Credentialing

Payer enrollment

Healthcare administration

Data management

Education

High school diploma or GED

Associate's degree

Bachelor's degree

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

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.
• 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.

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.