Provider Enrollment Specialist (Credentialing)
27 days ago
Miami
Job Description Seeking a full-time in-person credentialing specialist to join our large pediatric multi-specialty practice. Flexible work hours available. SUMMARY: Coordinates all functions related to the credentialing and recredentialing of health care providers with both hospitals and payers and maintains provider credentialing files. DUTIES AND RESPONSIBILITIES: • Receives and processes all initial credentialing and recredentialing applications., • Collects all pertinent information from the provider, provider’s malpractice insurer, National Practitioner Data Bank (NPDB) and other sources as deemed appropriate., • Ensures that credentialing and recredentialing of providers occurs on a timely basis in accordance with industry and company standards and criteria., • Maintains accurate and complete records of each application’s status., • Enters all provider information into database., • Prepares all documents to be reviewed by hospital Credentialing Committees, • Maintains all credentialing and recredentialing timelines and schedules., • Maintains strict level of confidentiality on all matters pertaining to provider., • Maintains well-organized provider files that are easily reviewed by credentialing committee, outside review bodies, and others., • Processes approval, denial, or termination letters., • Performs other related duties as assigned by management. QUALIFICATIONS: • Bachelors degree, or associates degree with equivalent experience and training, • 2+ years experience in provider credentialing strongly preferred, • Commitment to excellence and high standards, • Excellent written and oral communication skills, • Ability to manage priorities and workflow, • Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm, • Ability to work independently and as a member of various teams and committees, • Proficient on Microsoft Word and Excel. Experience using credentialing software strongly preferred., • Acute attention to detail, • Demonstrated ability to plan and organize projects, • Able to work collaboratively with multiple health professionals in a busy and complex environment using tact, diplomacy, and discipline., • Ability to communicate professionally and effectively in person, on the phone, electronically, or through other means to individuals and groups. JOB TYPE / WORK SCHEDULE: • This is a full-time position, in-office position, • Standard office hours, Monday – Friday, • Bilingual Preferred Competitive pay and a full benefits package, including 401(k), health, dental, vision, life, and disability insurance.