Credentialing Specialist

7 days ago

Lutz, Florida, United States MyCare Medical Group Full time
Job Title: Credentialing Specialist

We are seeking a highly skilled Credentialing Specialist to join our team at MyCare Medical Group. As a Credentialing Specialist, you will play a critical role in ensuring that our medical providers are properly credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities.

Key Responsibilities:
  • Process initial credentialing and re-credentialing applications for medical providers
  • Screen practitioners' applications and supporting documentation to ensure eligibility
  • Identify discrepancies in information and conduct follow-ups to resolve issues
  • Maintain internal and external databases, including CAQH, PECOS, and NPPES
  • Assist patients with credentialing inquiries and respond to health plan provider inquiries
  • Ensure timely renewal of licenses and certifications for medical providers
  • Audit Health Plan Directory and perform provider roster reconciliation
  • Initial and reappointment of hospital privileges
  • Internal and external support for health plan issue resolution
Requirements:
  • High school diploma/GED required
  • 1+ years of experience working in a health maintenance organization, health plan, provider office, or other health insurance-related setting
  • Experience with Managed Care Organizations (MCO's) and Centers for Medicare & Medicaid Services (CMS) credentialing and registration requirements
  • Ability to build professional cross-functional working relationships among all levels of the organization
  • Ability to make valid judgments, formulate recommendations or action plans, and evaluate the effects of decisions and actions
Knowledge, Skills, Abilities:
  • Intermediate computer skills, including Microsoft Office, especially Word, Excel, and PowerPoint
  • Excellent interpersonal skills, including the ability to interact effectively and professionally with individuals at all levels, both internal and external
  • Self-motivated with strong organizational skills and superior attention to detail
  • Ability to manage multiple tasks/projects simultaneously within inflexible time frames and adapt to frequent priority changes
Benefits:
  • Comprehensive benefits package, including Health, Vision, Dental, and Life insurances
  • FSA and Life Assistance Program (EAP)
  • 401(k) Retirement Plan
  • Health Advocacy, Travel Assistance, and My Secure Advantage
  • PTO Accrual and Holidays

  • Credentialing Specialist

    2 weeks ago

    Lutz, Florida, United States MyCare Medical Group Full time

    Job Title: Credentialing SpecialistWe are seeking a highly skilled Credentialing Specialist to join our team at MyCare Medical Group. As a Credentialing Specialist, you will play a critical role in ensuring that our medical providers are properly credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities.Key...

  • Credentialing Specialist

    7 days ago

    Lutz, Florida, United States MyCare Medical Group Full time

    Job Title: Credentialing SpecialistWe are seeking a highly skilled Credentialing Specialist to join our team at MyCare Medical Group. As a Credentialing Specialist, you will play a critical role in ensuring that our medical providers are credentialed, appointed, and privileged with health plans, hospitals, and patient care facilities.Key...

  • Credentialing Specialist

    4 weeks ago

    Lutz, Florida, United States MyCare Medical Group Full time

    Job DescriptionOverview of Position:MyCare Medical Group is seeking a highly skilled Credentialing Specialist to join our team. This position is based in our Central Business Office in Lutz, FL, and we are looking for individuals who live within a commutable distance.Key Responsibilities:Process initial credentialing and re-credentialing applications for...

  • Billing Specialist

    1 week ago

    Lutz, Florida, United States Suncoast Skin Solutions Full time

    Job Title: Billing SpecialistJob Summary:We are seeking a highly organized and detail-oriented Billing Specialist to join our team at Suncoast Skin Solutions. As a Billing Specialist, you will be responsible for submitting claims and following up with insurance companies, collecting, posting, and managing account payments.Key Responsibilities:Prepare and...

  • Cardiac Catheterization Specialist

    2 weeks ago

    Lutz, Florida, United States BayCare Health System Full time

    Job SummaryWe are seeking a skilled Cardiovascular Interventional Tech to join our team at BayCare Health System. As a member of our Cardiovascular and Interventional Services Team, you will assist in the performance of diagnostic and invasive procedures.Key ResponsibilitiesScrub in for procedures, including cardiac catheterizations and pacemaker...

  • Dietitian Specialist

    3 weeks ago

    Lutz, Florida, United States BayCare Health System Full time

    Revolutionize Healthcare with BayCare Health SystemBayCare Health System is a leading healthcare provider that is transforming the way healthcare is delivered. We are seeking a highly skilled Registered Dietitian to join our team at St. Joseph's North Hospital in Lutz, FL.About the RoleAs a Registered Dietitian, you will be responsible for providing optimal...

  • Dietitian Specialist

    2 weeks ago

    Lutz, Florida, United States BayCare Health System Full time

    Revolutionize Healthcare with BayCare Health SystemBayCare Health System is a leading healthcare provider that is transforming the way healthcare is delivered. We are seeking a highly skilled Registered Dietitian to join our team at St. Joseph's North Hospital in Lutz, FL.About the RoleAs a Registered Dietitian, you will be responsible for providing optimal...

  • Nurse Practitioner

    2 weeks ago

    Lutz, Florida, United States IVX Health Full time

    About IVX HealthIVX Health is a national provider of infusion and injection therapy for patients with complex chronic conditions. We're committed to delivering exceptional, personalized care experiences and empowering our team to succeed.Job SummaryWe're seeking a skilled Nurse Practitioner to join our team in a PRN capacity. As a key member of our clinical...

  • Protection and Control Specialist

    2 weeks ago

    Lutz, Florida, United States Insight Global Full time

    Job Title: Protection Control EngineerWe are seeking a highly skilled Protection Control Engineer to join our team at Insight Global. As a key member of our engineering team, you will be responsible for providing substation protection and control design, engineering, technical support, and oversight to our transmission substation engineering and design...