Credentialing Specialist
On-siteWest Palm Beach, Florida, United States
Job Summary
Manage the full lifecycle of provider credentialing, recredentialing, and privileging for medical providers across Cancer Center of South Florida locations. Prepare and submit enrollment applications for new and existing providers, while maintaining accurate data in credentialing systems and tracking trackers. Monitor application statuses across all active submissions and follow up with payers, hospital medical staff offices, and licensing bodies to keep things moving. Track expiration dates for licenses, certifications, DEA registrations, and payer enrollments, initiating renewals well ahead of deadlines. Serve as the primary point of contact for assigned providers, collecting documentation and escalating stalled enrollments to the Director of Credentialing. Collaborate with Revenue Cycle, Recruiting, and Operations to coordinate enrollment timelines and resolve billing-related credentialing issues.
Required Qualifications
- High school diploma or equivalent
- 2+ years of experience in provider credentialing, payer enrollment, or a related healthcare administrative role
- Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources
Desired Qualifications
- Associate's or Bachelor's degree in Healthcare Administration or related field
- CPCS certification
- Knowledge of payer enrollment processes, CAQH, and hospital privileging requirements
- Knowledge of credentialing software and payer enrollment portals
- Skill in managing multiple deadlines simultaneously without sacrificing accuracy
- Ability to communicate proactively and professionally with providers and internal stakeholders
- Ability to identify problems early and escalate appropriately
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