Credentialing Specialist Florida

Job Summary

To support managed care operations, the full-time Credentialing Specialist Florida will conduct internal file audits, manage credentialing databases, and ensure compliance with regulatory standards while working fully remote.

Key responsibilities

• Assist with managed care delegated credentialing audits and conduct internal file audits
• Monitor the credentialing process for employed physicians and allied health professionals, ensuring compliance with medical staff bylaws and policies
• Prepare credentials files for presentation to credentialing committees and respond to inquiries regarding credentialing and privileging issues

Required qualifications

• High School Diploma or equivalent required; Associate's degree preferred in Healthcare Administration, Business, or a related field
• Minimum of 1 year of administrative support experience in a healthcare setting required
• Knowledge of medical credentialing and privileging procedures and standards
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook)
• Ability to conduct thorough background investigations and primary source verifications