Credentialing Specialist - Healthcare Provider Enrollment

HOME PHYSICIANS GROUP; Orlando (FL); On-site; USD 48,000 - 64,000; Full time

Job summary

Home Physicians Group is seeking a Credentialing Specialist to coordinate all aspects of provider credentialing, recredentialing, and payer enrollment in a fast-paced healthcare environment.

The ideal candidate will have 2+ years in credentialing or healthcare administration, experience with enrollment, and familiarity with CAQH, PECOS, and payer portals. This role supports audits and accreditation while maintaining provider files and records.

Qualifications

• Minimum 2 years in credentialing or healthcare administration.
• Experience with provider credentialing and payer enrollment.
• Familiarity with CAQH, PECOS, and payer portals preferred.

Responsibilities

• Coordinate initial credentialing and recredentialing for physicians and APPs.
• Complete and maintain provider enrollment with Medicare, Medicaid, and commercial plans.
• Monitor credential expiration dates, licenses, certifications, and malpractice coverage.
• Maintain accurate provider files and credentialing databases.
• Communicate with providers, payers, hospitals, facilities, and regulators 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

Credentialing experience

Healthcare administration

Provider enrollment

Communication

Education

Associate's or Bachelor's degree preferred

Tools

CAQH

PECOS

Payer portals

Job description

Home Physicians Group is seeking a Credentialing Specialist to coordinate all aspects of provider credentialing, recredentialing, and payer enrollment in a fast-paced healthcare environment.

The ideal candidate will have 2+ years in credentialing or healthcare administration, experience with enrollment, and familiarity with CAQH, PECOS, and payer portals. This role supports audits and accreditation while maintaining provider files and records.