Credentialing Specialist

Nova Medical Services•Kendall, FL

12d•$18 - $25•Onsite

About The Position

Nova Medical Services is seeking an experienced and detail-oriented Credentialing Specialist to join their team in their Kendall office. This role is responsible for managing the credentialing and recredentialing process for healthcare providers while ensuring compliance with federal, state, payer, and accreditation requirements. The ideal candidate is highly organized, bilingual in English and Spanish, and has a strong understanding of healthcare insurance plans and credentialing procedures.

Requirements

2–4 years of credentialing experience in a medical or healthcare setting required.
Bilingual in English and Spanish (written and verbal).
Strong knowledge of provider credentialing, enrollment, healthcare insurance plans, and payer requirements.
Exceptional attention to detail and organizational skills.
Excellent time management and ability to manage multiple priorities.
Proficient in Microsoft Office (Word, Excel, Outlook) and credentialing software.
Strong communication and interpersonal skills.

Nice To Haves

Knowledge of medical terminology and healthcare regulations.

Responsibilities

Process provider credentialing and recredentialing applications accurately and efficiently.
Verify provider qualifications, licenses, certifications, malpractice coverage, and other required documentation.
Maintain compliance with federal, state, payer, and accreditation guidelines.
Coordinate with insurance carriers, healthcare organizations, and providers regarding credentialing status.
Maintain accurate electronic credentialing records and ensure documentation is current.
Monitor credential expiration dates and proactively manage renewals.
Research and resolve credentialing discrepancies in a timely manner.
Communicate regularly with providers and internal departments regarding credentialing updates.
Prioritize multiple projects while meeting strict deadlines.