Credentialing and Provider Onboarding Specialist

1 day ago


Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full time

We are seeking a skilled Credentialing Specialist to join our team at Doctors Healthcare Plans, Inc. as an onsite member. This role is not remote and requires strong organizational skills and attention to detail.

As a Credentialing Specialist, you will be responsible for maintaining an efficient provider credentials system by ensuring completed CAQH profiles and applications are received and processed. You will also provide data entry and clerical support to the Credentialing Department, assisting with the timely processing of initial credentialing and recredentialing applications.

Key responsibilities include:

  • Processing practitioner credentialing and recredentialing application packets, reviewing each packet for completeness and requesting missing data from practitioners' offices or contracting department staff;
  • Creating new electronic records in the credentialing database and performing data entry for initial and reappointment practitioners;
  • Requesting state licenses, DEA certificates, liability insurance, and other necessary documents via phone, email, fax, or mail;
  • Maintaining delegated entities' files, submitted documents, and performing data changes;
  • Filing or scanning received documents;
  • Assisting the Credentialing Director or designee with various tasks as needed;
  • Receiving, sorting, and distributing incoming mail and faxes as required.

To be successful in this role, you should have a minimum of two years of experience in a managed care organization's Credentialing department. NAMSS CPCS certification is preferred, but not required. You should also possess excellent organizational skills, be detail-oriented, and have good verbal communication skills.

The estimated salary for this position is $55,000 - $65,000 per year, depending on location and experience. We offer a competitive benefits package, including health insurance, retirement plans, and paid time off.

At Doctors Healthcare Plans, Inc., we value diversity and inclusion in the workplace. We welcome applications from qualified candidates who can contribute to our team's success.


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