Healthcare Provider Credentialing Specialist

MCR Health, Inc; Bradenton (FL); On-site; USD 48,000 - 64,000; Full time

Job summary

The Provider Enrollment Specialist assists with all aspects of the insurance provider enrollment process for MCR Health, Inc. The Credentialing Specialist maintains relations with payers, clinics, and providers to ensure timely participation status and compliance.

Based in Bradenton, FL, this role supports provider enrollment for government programs and commercial networks. The position requires strong communication, medical terminology knowledge, and the ability to work with minimal supervision.

Qualifications

• Two years of healthcare insurance experience.
• Provider enrollment experience preferred.
• Knowledge of Medicaid, Medicare, and private insurance.
• Basic Microsoft Excel skills; advanced skills preferred.
• Strong interpersonal and written/oral communication.
• Ability to meet deadlines and work with minimal supervision.
• Medical terminology knowledge is helpful.
• High School Graduate or GED equivalent.

Responsibilities

• Complete insurance enrollment applications following standards, regulations, guidelines & laws.
• Responsible for initial credentialing with insurance companies.
• Ensure credentialing and re-credentialing is completed promptly for providers and the organization.
• Notify managers of credentialing issues, status on applications, changes with plans.
• Handle telephone communications regarding provider participation and documentation.
• Obtain signatures in the field to complete credentialing.
• Support the goals and mission of MCR Health.
• Adhere to safety policy; perform other duties as assigned.

Skills

Interpersonal skills

Microsoft Excel

Education

High School Diploma or GED

Tools

Microsoft Excel

Job description

The Provider Enrollment Specialist assists with all aspects of the insurance provider enrollment process for MCR Health, Inc. The Credentialing Specialist maintains relations with payers, clinics, and providers to ensure timely participation status and compliance.

Based in Bradenton, FL, this role supports provider enrollment for government programs and commercial networks. The position requires strong communication, medical terminology knowledge, and the ability to work with minimal supervision.