Credentialing/Provider Enrollment Specialist | Managed Care & Corporate Development

Overview

Supporting the Network Behind Exceptional Care. 💻 Work Style: Hybrid (Onsite training for first 2 months, then hybrid schedule) 📍 Location: Gainesville, FL 🕒 FTE: Full-Time (1.0 FTE) ⏰ Schedule: Monday – Friday - 8:00 am to 5:00 pm

Responsibilities

• Verifies and authenticates the credentials of healthcare professionals to ensure compliance with regulatory standards.
• Collaborates with medical staff and external agencies to collect and review necessary documentation, maintaining accurate credentialing records, and monitoring expiration dates for timely renewals.
• Supports audit and accreditation processes by preparing reports and documentation.
• Communicates credentialing requirements to stakeholders.
• Affords assistance to the credentialing committee with meeting coordination.
• Resolves discrepancies and follows up on incomplete credentialing information to maintain data integrity and compliance.
• Works collaboratively with Managed Care, Credentialing, Revenue Cycle, Medical Staff, Operations, and IT teams to support provider onboarding, enrollment maintenance, payor reporting, and operational workflow coordination across the health system.

Qualifications

• Associate’s or Bachelor’s degree in Healthcare Administration, Business Administration, or a related field required; equivalent work experience may be considered in lieu of education
• 3+ years of experience in healthcare credentialing, provider enrollment, or medical staff services
• Knowledge of healthcare regulatory requirements, credentialing standards, and accreditation processes
• Experience managing credentialing documentation, primary source verification, and provider renewal processes
• Strong organizational, communication, and record management skills
• Ability to coordinate effectively with medical staff, providers, licensing boards, payers, and external agencies