Credentialing/Provider Enrollment specialist

State
FL

Job Type
Full-Time Regular

Date Posted
3/14/2025

Compensation
5% bonus

Job Description

Flybridge Staffing is currently searching for a Credentialing/Provider enrollment specialist to join a growing client in the Boca Raton area. This is a permanent position that will work off a hybrid schedule after 90 days.

This person will assist in the insurance credentialing/re-credentialing process by coordinating and assisting the Insurance Services department in the resolution of issues and cases. Compiles runs, and completes various insurance-related reports and presentations for management. Liaison between insurance carriers, commercial and federal clearing houses, federal regulatory credentialing as well as, state, county, and federal licensing on behalf of affiliated physicians for insurance credentialing/re-credentialing.

Responsibilities:

Coordinates all aspects of the credentialing process while delivering top-quality customer service.
Enter all pertinent data from applications into the credentialing system and run daily/weekly reports, etc.
Maintaining credentialing system processes, policies, and procedures, and ensuring adherence to all requirements.
Identifying pertinent credentialing matters and providing analysis and resolution to management weekly.
Establishes and communicates timelines with corporate affiliates or practices to ensure that schedules are met.
Prepares, reviews, and sends status reports on an as-needed basis to affiliated physicians and stakeholders. Follows-up to ensure closure on outstanding cases.
Help assess all credentialing related materials and reports and coordinate with outside staff to verify all outside processes are completed.
Provides analysis and recommendations to management for escalated issues. Assists in resolving escalated issues and urgent requests.

Qualifications:

Associate degree and at least two years related business experience; or equivalent
Certified Provider Credentialing Specialist (CPCS) is highly desired.
Experience with coordination or management of credentialing/re-credentialing processes for primary care physicians is highly desired.
Insurance experience and healthcare knowledge are preferred.
Must be able to develop a thorough knowledge of CAQH, PECOS & NPPES applications.
CRM, EMR, and/or credentialing software experience required.
Net Docs, credentialing software, Athena, and Salesforce experience preferred.

If your background aligns with the above details and you would like to learn more, please send your resume to jobs@flybridgestaffing.com or on our website, www.flybridgestaffing.com and one of our recruiters will be in touch with you ASAP.