Credentialing Specialist
2 days ago
We are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at Doctors Healthcare Plans, Inc. The successful candidate will be responsible for maintaining an efficient provider credentials system, ensuring completed credentials CAQH profiles and/or applications are received and processed, and providing data entry and clerical support to the Credentialing Department.
Key Responsibilities:- Process practitioner credentialing and recredentialing application packets, including reviewing each application for completeness and requesting missing data from practitioner offices and/or Contracting Department staff.
- Create new electronic records in the credentialing database and perform data entry of all Initial (new) and Reappointment (recredential) Practitioners credentials applications.
- Request and obtain State licenses, DEA certificates, Liability insurance, National Practitioner Database (NPDB) Report, Office of Inspector General (OIG) reports, Board certification, School/Residency/Fellowship completion, Hospital privileges verification, System Award Management (SAM), Claims history, Accreditation (ancillary facilities), and Site Visits as needed.
- Process and maintain delegated entities' files, submitted documents, and perform data changes, including State licenses, DEA certificates, Liability insurance, NPDB report, OIG reports, SAM report, Board certification, Hospital privileges verification, claims history, Accreditation (ancillary facilities), and obtaining additional information or clarification from practitioner offices as needed.
- Assist the Credentialing Director or designee with various tasks, as needed, and receive, sort, and distribute incoming mail and faxes as needed.
- Minimum of two (2) years previous experience in a managed care organization's Credentialing department.
- NAMSS CPCS certification is preferred, or a commitment to pursue certification within two years.
- Knowledge of basic medical terminology, ability to analyze data and make appropriate decisions, and ability to work as a team under stressful conditions.
- Good verbal communication skills, bilingual English and Spanish (preferred but not required), excellent organizational skills, and extremely detail-oriented.
- Ability to maintain confidentiality, minimum typing skills of 45 WPM, and PC proficiency and Windows-based software knowledge (Microsoft Word, Excel, Outlook) required.
Our Company: Doctors Healthcare Plans, Inc. is committed to creating a diverse environment and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
-
Credentialing Specialist
2 days ago
Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full timeJob Title: Credentialing SpecialistDoctors Healthcare Plans, Inc. is seeking a highly organized and detail-oriented Credentialing Specialist to join our team. As a Credentialing Specialist, you will play a critical role in maintaining an efficient provider credentials system by ensuring completed credentials CAQH profiles and/or applications are received and...
-
Credentialing Specialist
2 days ago
Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full timeJob Title: Credentialing SpecialistWe are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at Doctors Healthcare Plans, Inc. The successful candidate will be responsible for maintaining an efficient provider credentials system, ensuring completed credentials CAQH profiles and/or applications are received and processed,...
-
Credentialing Specialist
2 weeks ago
Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full timeJob SummaryWe are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at Doctors Healthcare Plans, Inc. The successful candidate will be responsible for maintaining an efficient provider credentials system, ensuring completed credentials CAQH profiles and/or applications are received and processed, and providing data...
-
Credentialing Specialist
13 hours ago
Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full timeJob Summary:Doctors Healthcare Plans, Inc. is seeking a skilled Credentialing Specialist to join our team. The successful candidate will be responsible for maintaining an efficient provider credentials system, ensuring completed credentials CAQH profiles and/or applications are received and processed, and providing data entry and clerical support to the...
-
Credentialing Specialist
1 day ago
Coral Gables, Florida, United States DOCTORS HEALTHCARE PLANS, INC. Full timeJob Summary:We are seeking a highly organized and detail-oriented Credentialing Specialist to join our team at Doctors Healthcare Plans, Inc. The successful candidate will be responsible for maintaining an efficient provider credentials system, ensuring completed credentials CAQH profiles and/or applications are received and processed, and providing data...
-
Critical Care Specialist
4 weeks ago
Coral Gables, Florida, United States ScionHealth - Kindred Cornerstone & Solara Hospitals Full timeJob Title: Critical Care SpecialistScionHealth - Kindred Cornerstone & Solara Hospitals is seeking a skilled Critical Care Specialist to join our team in Coral Gables, Florida.Job SummaryWe are committed to a culture of service excellence, and our Critical Care Specialists play a vital role in delivering exceptional patient care. As a Critical Care...
-
Orthopedic Soft Goods Specialist
3 weeks ago
Coral Gables, Florida, United States DJO Global Full timeAbout the RoleWe are seeking a highly skilled and dedicated individual to join our team as a Field Service Representative in Coral Gables, FL. As a key member of the Field Services Team, you will play an integral part in helping us drive the medical technology industry forward through transforming patient care and creating better patient...
-
Donor Referral Specialist
3 weeks ago
Coral Gables, Florida, United States InsideHigherEd Full timeJob SummaryWe are seeking a highly skilled and dedicated Donor Referral Responder to join our team. As a key member of our organ procurement organization, you will play a critical role in responding to potential donor referrals, directing logistical support, and providing information to healthcare professionals.Key ResponsibilitiesRespond to potential donor...
-
Staff Physician
2 weeks ago
Coral Gables, Florida, United States University of Miami Full timeJob SummaryWe are seeking a highly skilled and dedicated Staff Physician to join our team at the University of Miami. As a Staff Physician, you will be responsible for providing world-class primary care in an ambulatory clinic setting, adhering to UHealth policies and standards of practice.Key ResponsibilitiesDeliver high-quality primary care to a...
-
Insurance Verification Specialist
3 weeks ago
Coral Springs, Florida, United States Health Advocates Network Full timeJob Title: Insurance Verification SpecialistWe are seeking a highly organized and detail-oriented Insurance Verification Specialist to join our team at Health Advocates Network. As an Insurance Verification Specialist, you will be responsible for verifying insurance coverage requirements, exclusions, and limitations for patients.Key Responsibilities:Verify...
-
Insurance Verification Specialist
4 weeks ago
Coral Springs, Florida, United States Health Advocates Network Full timeJob Title: Insurance Verification SpecialistWe are seeking a highly skilled Insurance Verification Specialist to join our team at Health Advocates Network. As an Insurance Verification Specialist, you will be responsible for verifying insurance coverage requirements, exclusions, and limitations for patients. This is a temporary-to-hire position at a dynamic...
-
Physical Therapist
2 weeks ago
Cape Coral, Florida, United States Centra Healthcare Allied Full timeJob Title: Physical Therapist - Rehabilitation SpecialistCentra Healthcare Allied is seeking a skilled Physical Therapist to join our team in Cape Coral, Florida.Job Summary:We are looking for a highly motivated and experienced Physical Therapist to work in a rehabilitation setting. The ideal candidate will have a strong background in physical therapy and be...
-
Interventional Radiographer Specialist
4 weeks ago
Coral Springs, Florida, United States Broward Health Full timeBroward Health Coral Springs ShiftShift 1FTE:0.Summary:Performs a variety of invasive media diagnostic tests and coordinates the imaging of internal organs and issues. Supports quality patient care and services.Education:Associate PreferredGraduate from an AMA approved School of Radiology Technology or of an accredited RCIS ProgramRadiologic Technology...
-
Mental Health Specialist
9 hours ago
Cape Coral, Florida, United States Seasoned Recruitment Full timeWe are seeking a skilled and compassionate Mental Health Specialist to deliver exceptional psychiatric care to our patients.As a key member of our team, you will collaborate with our healthcare professionals to ensure the highest level of patient care.Key Responsibilities:Providing top-quality psychiatric care to patientsCollaborating with our team to ensure...
-
PRN CT Imaging Specialist
2 weeks ago
Cape Coral, Florida, United States Millennium Physician Group Full timePosition OverviewCT Imaging SpecialistEmployment Type: PRN, Weekday Shifts OnlyLocation: Serving Lee & Collier CountiesOverview: This role is on a PRN basis, requiring flexibility in working hours as necessary.Millennium Physician Group is eager to welcome a part-time CT Imaging Specialist to our dedicated Imaging Team. We seek an individual who is...
-
Travel Physical Therapist
1 month ago
Cape Coral, Florida, United States Centra Healthcare Allied Full timeJob SummaryCentra Healthcare Allied is seeking a skilled Physical Therapist to join our team as a contract Rehabilitation Specialist. This is a 13-week travel assignment in Cape Coral, Florida, with a guaranteed 40 hours per week and 8 hours per shift.Key ResponsibilitiesProvide high-quality rehabilitation services to patients in a hospital or clinical...
-
Travel Cardiac Technician
17 hours ago
Cape Coral, Florida, United States MedPro Healthcare Allied Staffing Full timeJob Title: Cardiac Ultrasound SpecialistMedPro Healthcare Allied Staffing is seeking a skilled Cardiac Ultrasound Specialist for a travel job in a top healthcare facility.Job Description & RequirementsSpecialty: Cardiac UltrasoundDiscipline: Allied Health ProfessionalDuration: 13 weeks40 hours per weekShift: 10 hours, daysEmployment Type: TravelMedPro...
-
Traveling Physical Therapist
3 weeks ago
Coral Springs, Florida, United States Jackson Therapy Full timeJob Title: Travel Outpatient Physical TherapistWe are seeking a skilled and dedicated Physical Therapist to join our team for a travel assignment in an outpatient setting.About the JobThis is a 13-week assignment with 40 hours per week, 8 hours per shift. The ideal candidate will have a strong background in physical therapy and excellent communication...
-
Physiatrist - Full Time Opportunity
3 weeks ago
Cape Coral, Florida, United States Centra Healthcare Solutions Full timeJoin Our Team as a Rehabilitation SpecialistCentra Healthcare Solutions is seeking an experienced Physical Therapist (PT) to work in the specialty area of Rehabilitation. This is a contract, 5x8 Days position that requires licensure or immediate licensure eligibility in the state of FL.Key Responsibilities:Provide high-quality patient care in a...
-
Cardiovascular Technologist
4 weeks ago
Coral Springs, Florida, United States Broward Health Full timeBroward Health Job OpportunityWe are seeking a skilled Cardiovascular Technologist to join our team at Broward Health Coral Springs.Job Summary:Assist cardiologists in performing diagnostic and interventional procedures in the cardiovascular lab, including angioplasty with stenting and related procedures. Monitor radiation safety for physicians, patients,...