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Credentialing Specialist Jobs in Plantation, FL (NOW HIRING)

NuView Health

Credentialing Specialist

Boca Raton, FL · On-site

The Credentialing Specialist ensures the accuracy and integrity of the credentialing database and related applications while maintaining compliance with all applicable standards and regulations.

Private Practice

Credentialing Specialist

Miami, FL · On-site

Credentialing Specialist REPORTS TO: Revenue Cycle Manager FLSA STATUS: Non-Exempt QUALIFICATIONS/EDUCATION: * AA Degree required. * Minimum two years of experience in healthcare credentialing.

Brightwing

Credentialing Specialist

Davie, FL

The Credentialing Specialist is responsible for credentialing and re-credentialing of practitioners as well as ensuring enrollment with participating client health plans. Credentialing functions ...

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How much do credentialing specialist jobs pay per hour?

As of May 27, 2026, the average hourly pay for credentialing specialist in Plantation, FL is $24.19, according to ZipRecruiter salary data. Most workers in this role earn between $19.09 and $27.45 per hour, depending on experience, location, and employer.

What Is a Credentialing Specialist?

Credentialing specialists verify the qualifications of the staff in healthcare organizations for healthcare organizations. This verification process ensures that doctors and other medical professionals provide accurate education and work histories, and confirms that they meet all local and federal licensing and regulation requirements before they are hired or contracted with a medical facility. Credentialing specialists are part of an organization's administrative staff; they review medical policies, process contracts, and facilitate audit reports to validate that certified medical professionals comply with credentialing procedures. They also update medical databases with information about a physician’s training or license and document when credentials must be renewed.

What are the key skills and qualifications needed to thrive as a Credentialing Specialist, and why are they important?

To thrive as a Credentialing Specialist, you need a strong understanding of credentialing processes, attention to detail, and familiarity with healthcare regulations, typically supported by a relevant associate’s or bachelor’s degree. Proficiency with credentialing software, databases, and document management systems is commonly required, along with knowledge of standards such as NCQA or Joint Commission. Exceptional organizational skills, effective communication, and the ability to manage deadlines help professionals excel in this role. These competencies ensure accurate provider verification and compliance, which are critical for patient safety and institutional accreditation.

What are some typical challenges a Credentialing Specialist faces when coordinating with healthcare providers and insurance companies?

Credentialing Specialists often encounter challenges such as managing incomplete or inconsistent provider documentation, meeting strict deadlines, and navigating varying requirements from different insurance companies or healthcare facilities. Effective communication and organizational skills are essential, as the role requires frequent follow-up with providers and close coordination with multiple internal departments. Staying updated on regulatory changes and ensuring all files remain compliant can also be demanding but is critical for maintaining smooth healthcare operations.

What are Credentialing Specialists?

Credentialing Specialists are professionals responsible for verifying the qualifications and backgrounds of healthcare providers and ensuring they meet the standards required by hospitals, insurance companies, and regulatory bodies. They collect, review, and process documentation such as licenses, certifications, education, and work history. Their work ensures that only properly qualified professionals are allowed to provide care, helping maintain patient safety and organizational compliance. Credentialing Specialists often work in healthcare facilities, insurance companies, or third-party credentialing organizations.

What is the difference between Credentialing Specialist vs Medical Biller?

AspectCredentialing SpecialistMedical Biller
Required CredentialsCertification in healthcare credentialing, knowledge of insurance and provider databasesCertification in medical billing, coding, or related areas often preferred
Work EnvironmentHealthcare facilities, insurance companies, or credentialing agenciesMedical offices, billing companies, healthcare providers
Employer & Industry UsageUsed in healthcare to verify provider credentials for insurance and licensingUsed in healthcare to process and submit medical claims for reimbursement

The Credentialing Specialist focuses on verifying healthcare providers' credentials to ensure compliance and eligibility, while the Medical Biller handles billing and claims processing for healthcare services. Both roles are essential in healthcare administration but serve different functions within the industry.

More about Credentialing Specialist jobs
What are the most commonly searched types of Credentialing Specialist jobs in Plantation, FL? The most popular types of Credentialing Specialist jobs in Plantation, FL are:
What are popular job titles related to Credentialing Specialist jobs in Plantation, FL? For Credentialing Specialist jobs in Plantation, FL, the most frequently searched job titles are:
What cities near Plantation, FL are hiring for Credentialing Specialist jobs? Cities near Plantation, FL with the most Credentialing Specialist job openings:
Credentialing Specialist jobs near you
Infographic showing various Credentialing Specialist job openings in Plantation, FL as of May 2026, with employment types broken down into 100% Full Time. Highlights an 100% In-person job distribution, with an average salary of $50,325 per year, or $24.2 per hour.

Credentialing Specialist

Nuview Telehealth

Boca Raton, FL • On-site

Full-time

Posted 11 days ago

Job description

Description:

Summary


The Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing processes for NuView Health. This includes facilitating initial hospital appointments, reappointments, and the management of expirables, as well as completing medical licensing applications. The Credentialing Specialist ensures the accuracy and integrity of the credentialing database and related applications while maintaining compliance with all applicable standards and regulations.


Duties and Responsibilities

  • Oversee and coordinate the onboarding process for new physicians and allied health professionals.
  • Conduct comprehensive background checks, research, and primary source verification for all credentialing applications.
  • Manage the entire credentialing and re-credentialing process for medical and allied health staff.
  • Identify and resolve issues or discrepancies, ensuring thorough investigation and appropriate follow-up.
  • Ensure timely and accurate processing and verification of credentials, licenses, certifications, and supporting documentation.
  • Maintain effective communication with physicians and allied health professionals, leadership, and regulatory agencies regarding credentialing status and requirements.
  • Assist hospital Medical Staff Offices with follow-up on outstanding verifications, ensuring timely file completion.
  • Respond to inquiries from healthcare organizations and interface with internal and external clients on credentialing and privileging issues.
  • Utilize the credentialing database for optimizing efficiency; perform queries, reporting, and document generation.
  • Monitor and track expirables (licenses, certifications, etc.) for all medical staff.
  • Prepare and review initial and renewal state medical license applications for practitioner submission.
  • Perform other related duties as assigned.
Requirements:

Minimum Job Requirements

  • Education: Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field preferred.
  • Experience: Minimum 2 years in medical staff credentialing or healthcare administration required; experience in an acute care or hospital setting preferred.
  • Knowledge: Familiarity with medical credentialing and privileging procedures, standards, and regulatory requirements.


Knowledge, Skills and Abilities Required

  • Strong organizational and time-management abilities; able to multi-task effectively.
  • Excellent verbal and written communication skills.
  • High attention to detail and accuracy.
  • Proficiency in Microsoft Office Suite and credentialing software.
  • Ability to work both independently and as part of a team.
  • Knowledge of medical terminology, credentialing standards, and regulatory requirements.
  • Strong problem-solving and reasoning abilities.
  • Interpersonal skills to develop and maintain professional relationships.
  • Program planning and implementation skills.
  • Research and information-gathering skills.
  • Ability to exercise independent judgment and maintain confidentiality.
  • Database management skills, including querying, reporting, and document generation.
  • Demonstrated initiative and proactive approach to responsibilities.



Working Conditions and Physical Effort

  • Minimal to no exposure to physical risk.
  • Minimal physical effort required.
  • Work is performed in a standard office environment.

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