Credentialing Specialist

Growth Orthopedics•Coral Gables, FL

5d•Onsite

About The Position

Growth Orthopedics is seeking a highly organized and detail-oriented Credentialing Specialist to manage the full-cycle of provider credentialing and payer enrollment. This role is critical to ensuring our providers are approved, compliant, and ready to deliver care without disruption to patient access or revenue. The ideal candidate brings a strong sense of ownership, urgency, and follow-through, with the ability to navigate complex payer processes and keep multiple workstreams moving forward simultaneously.

Requirements

2+ years of credentialing or payer enrollment experience, preferably within a physician practice or multi-site healthcare organization
Strong understanding of Medicare, Medicaid, and commercial payer credentialing processes
Experience with PECOS, NPI, CAQH, and payer enrollment systems
Exceptional attention to detail and commitment to accuracy
Strong organizational skills with the ability to manage multiple priorities and deadlines
Proactive follow-up mindset with the ability to push processes forward
Ability to work independently while staying aligned with cross-functional teams
Clear and professional communication skills

Nice To Haves

Experience with credentialing software such as Modio, symplr, or Credstream is a plus

Responsibilities

Own the credentialing process end-to-end
Prepare, submit, and manage all initial credentialing, re-credentialing, and revalidation applications
Oversee Medicare, Medicaid, and commercial payer enrollments, including PECOS submissions and NPI/PTAN linkages
Maintain and attest CAQH profiles to ensure timely and accurate submissions
Partner directly with providers to collect and maintain all required documentation
Act as the primary point of contact with payers, proactively following up to move applications forward
Track application status and escalate delays when needed to ensure timely approvals
Resolve discrepancies and respond quickly to requests for additional information
Maintain organized, audit-ready credentialing records for all providers and locations
Track and manage expirations for licenses, certifications, DEA registrations, and malpractice coverage
Ensure all activities align with federal, state, and payer requirements
Maintain accurate tracking systems and credentialing records
Provide visibility into application status, expirations, and upcoming renewals
Support audits, payer reviews, and compliance initiatives
Partner with revenue cycle, billing, HR, compliance and operations to align credentialing with onboarding and billing readiness
Communicate clearly when providers are approved and ready for scheduling and billing
Support new provider onboarding by guiding them through the credentialing process