Find & Apply For Enrollment / Eligibility Specialist Jobs in Coral Gables, Florida

Seeking a full-time credentialing specialist to join our large pediatric multi-specialty practice. Flexible work hours available with the possibility of Hybrid schedule after 3 months.

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 - Hybrid after 3 months Standard office hours, Monday - Friday Bilingual Preferred Competitive pay and a full benefits package, including 401(k), health, dental, vision, life, and disability insurance.