Medical Staff & Payor Credentialing Specialist Position Available In Miami-Dade, Florida

Medical Staff & Payor Credentialing Specialist Monte Nido & Affiliates, LLC – 2.8

Miami, FL Job Details Full-time Estimated:

$45.4K – $58.7K a year 1 day ago Benefits Health savings account AD&D insurance Disability insurance Health insurance Dental insurance Flexible spending account Paid time off Employee assistance program Vision insurance Life insurance Qualifications Microsoft Excel BC/BE Mid-level High school diploma or GED Bachelor’s degree NCQA standards Organizational skills Associate’s degree Communication skills Behavioral health Full Job Description We save lives while providing the opportunity for people to realize their healthy selves.: Medical Staff & Payor Credentialing Specialist Monte Nido Remote For more than 25 years, Monte Nido has delivered proven treatment for eating disorders . Our programs offer a model of treatment that blends medically sophisticated care with a personalized treatment approach. Our treatment setting is intimate with a high staff-to-client ratio, and an emphasis on individual therapy and highly individualized treatment. We are seeking a Medical Staff & Payor Credentialing Specialist to join our centralized onboarding team. This remote role plays a critical part in ensuring licensed providers are onboarded efficiently and in full compliance with medical staff and payor requirements across a multi-site, multi-state organization. You’ll oversee both internal medical staff credentialing and external payor enrollment, working closely with stakeholders across clinical, operations, HR, and revenue cycle functions. This position is ideal for someone who thrives on precision, is comfortable working independently in a remote environment, and has a strong understanding of credentialing complexities across state lines.

Total Rewards:

: Discover a rewarding career with us and enjoy an array of comprehensive benefits! We prioritize your success and well-being, providing: Competitive compensation Medical, dental, and vision insurance coverage (Benefits At a Glance) Retirement Company-paid life insurance, AD&D, and short-term disability Employee Assistance Program (EAP) Flexible Spending Account (FSA) Health Savings Account (HSA) Paid time off Professional development And many more! We are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Responsibilities Include:

: Medical Staff Credentialing & Privileging Manage end-to-end credentialing and privileging processes for providers across multiple states and levels of care, in accordance with Monte Nido’s policies and Medical Staff Bylaws. Conduct primary source verifications for licensure, education, board certification, background checks, and NPDB queries. Coordinate review and approval workflows with clinical leaders and medical directors. Maintain comprehensive and audit-ready credentialing files and digital records. Track expirables and manage timely recredentialing for all licensed providers. Payor Enrollment & Maintenance Coordinate provider enrollment and recredentialing with commercial and government payors, including Medicaid and Medicare across multiple states. Manage CAQH profiles, complete attestation updates, and maintain enrollment tracking tools. Communicate with payors to resolve issues, ensure status updates, and avoid delays in reimbursement. Align enrollment timelines with provider start dates to support seamless billing and patient access. Team Collaboration & Process Improvement Act as a critical member of the onboarding team, participating in process improvement initiatives and onboarding planning. Provide updates on credentialing and enrollment status to internal stakeholders. Collaborate across Talent Acquisition, HR, Legal, Compliance, and Revenue Cycle to ensure successful onboarding and billing readiness. Support ongoing audits, reports, and compliance requirements for internal and external regulatory bodies.

Qualifications:

: 3+ years of credentialing and payor enrollment experience in a multi-site, multi-state healthcare environment (behavioral health experience preferred). Prior experience working remotely with a distributed team and managing credentialing across various state requirements. Knowledge of NCQA, Joint Commission, and/or CMS credentialing standards. Familiarity with CAQH, NPPES, PECOS, and major payor portals. Strong organizational skills, attention to detail, and ability to manage competing priorities and tight timelines. Proficiency in Excel and credentialing systems (e.g., MD-Staff, Symplr, or similar platforms). Excellent communication and collaboration skills across virtual environments. High school diploma required; associate’s or bachelor’s degree preferred. #montenido #LI-REMOTE