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Provider Enrollment Credentialing information

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How much do provider enrollment credentialing jobs pay per hour?

As of Aug 28, 2026, the average hourly pay for provider enrollment credentialing in Florida is $18.20, according to ZipRecruiter salary data. Most workers in this role earn between $14.38 and $20.67 per hour, depending on experience, location, and employer.

What is provider enrollment credentialing?

Provider enrollment credentialing is the process by which healthcare professionals and organizations are verified and approved to participate with insurance plans, government programs, and other payers. It involves collecting and validating information such as education, licenses, certifications, and work history to ensure providers meet specific standards. This process helps maintain the quality of care and compliance with regulations. Credentialing is essential for providers to be reimbursed for services and to ensure patient safety. The process can be lengthy and requires continual updates to maintain participation.

What are the key skills and qualifications needed to thrive as a provider enrollment credentialing specialist?

To thrive as a Provider Enrollment Credentialing Specialist, you need strong attention to detail, organizational skills, and a solid understanding of healthcare compliance and credentialing regulations, often supported by a relevant associate's or bachelor's degree. Familiarity with credentialing software, provider databases, and systems like CAQH, as well as knowledge of payer enrollment processes, is typically required. Excellent communication, problem-solving abilities, and the capacity to manage multiple tasks efficiently are standout soft skills in this role. These skills ensure accurate and timely provider enrollment, compliance with regulatory standards, and smooth healthcare operations.

What are some common challenges faced in a provider enrollment credentialing role, and how can they be addressed?

One of the main challenges in Provider Enrollment Credentialing is managing complex and ever-changing payer requirements, which can vary significantly between insurance companies and states. This often requires strong organizational skills and meticulous attention to detail to ensure timely and accurate submission of documentation. Effective communication with providers and payers is essential to resolve discrepancies quickly. Staying up-to-date with regulatory changes and maintaining a well-organized tracking system can help address these challenges and ensure a smoother credentialing process.

What is the difference between Provider Enrollment Credentialing vs Provider Enrollment Specialist?

AspectProvider Enrollment CredentialingProvider Enrollment Specialist
Primary RoleVerifies provider credentials, licenses, and certifications for insurance enrollmentManages the enrollment process, submits applications, and maintains provider records
Required CredentialsLicenses, certifications, and credentialing documentsKnowledge of enrollment procedures and documentation
Work EnvironmentHealthcare organizations, credentialing companiesInsurance companies, healthcare provider offices

Provider Enrollment Credentialing focuses on verifying provider qualifications, while Provider Enrollment Specialists handle the application process and ongoing enrollment management. Both roles are essential in ensuring providers are properly credentialed and enrolled with insurance plans.

What are popular job titles related to Provider Enrollment Credentialing jobs in Florida?

For Provider Enrollment Credentialing jobs in Florida, the most frequently searched job titles are:

What job categories do people searching Provider Enrollment Credentialing jobs in Florida look for?

The top searched job categories for Provider Enrollment Credentialing jobs in Florida are:

Provider Enrollment Credentialing jobs near you
Infographic showing various Provider Enrollment Credentialing job openings in Florida as of August 2026, with employment types broken down into 90% Full Time, 5% Part Time, and 5% Nights. Highlights an 63% In-person, 5% Hybrid, and 32% Remote job distribution, with an average salary of $37,861 per year, or $18.2 per hour.

Provider Enrollment & Credentialing Coordinator

Florida Orthopaedic Institute

Temple Terrace, FL • On-site

Other

Re-posted 18 days ago

Florida Orthopaedic Institute rating

8.7

Company rating: 8.7 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

Job description

Provider Enrollment & Credentialing Coordinator

The Provider Enrollment & Credentialing Coordinator is responsible for all aspects of provider enrollment, credentialing, recredentialing, and privileging processes for employed and contracted practitioners. This includes maintaining accurate provider data in credentialing databases, ensuring timely submission and renewal of required documentation and supporting compliance standards. The Coordinator will work closely with providers, payers, and internal departments to ensure practitioners are appropriately credentialed and enrolled to support timely patient access and reimbursement.

Responsibilities:

  • Coordinate initial credentialing and recredentialing for physicians, physician assistants, and advanced practice providers across Medicare, Medicaid, commercial insurers, and delegated payers.
  • Obtain and maintain NPI provider numbers utilizing the PECOS, Medicaid, Availity and NPPES websites.
  • Prepare Credentialing files for FOI Credentialing Committee. This would include completing all required primary source verifications.
  • Track and maintain provider insurance participation status and effective dates in Athena.
  • Maintain timely and accurate data entry in credentialing databases and payer portals; update provider rosters and profiles as needed.
  • Process facility privilege applications and reappointments of privileges.
  • Monitor and manage expirable documents (licenses, DEA, board certifications, malpractice insurance), alerting providers and escalating unresolved expirations to the Manager.
  • Submit and update provider information in the CAQH ProView system as required by participating health plans.
  • Ensure compliance with NCQA, URAC, CMS, and payer requirements for provider credentialing and enrollment.
  • Assist with issue resolution and communication with payers regarding credentialing/enrollment status and delays.
  • Upload and track CME documentation in relevant databases (e.g., CE Broker).
  • Communicate credentialing or enrollment issues and application delays to the Manager in a timely manner.
  • Participate in internal audits, special projects, and process improvements as directed.
  • Perform other duties as assigned by department leadership.

Education And Experience:

  • Healthcare administration, business, or a related field preferred.
  • Minimum 2 years of experience in provider credentialing or enrollment, preferably in a healthcare, medical group, or managed care environment.
  • Working knowledge of:
    • Credentialing standards (NCQA, URAC, CMS)
    • Credentialing software and payer enrollment systems
    • Proficiency in Microsoft Excel and Office Suite; comfort with electronic databases and file management systems.
  • Strong attention to detail, organization, and ability to manage multiple tasks and deadlines.
  • Effective verbal and written communication skills, especially in provider-facing interactions.
  • Ability to handle sensitive data with a high level of confidentiality and accuracy.

Prefferred Qualifications & Skills

  • Prior experience with delegated credentialing or payer audit support
  • Experience using Athenahealth and VerityStream platforms
  • Basic understanding of medical terminology and healthcare regulations
  • CPCS (Certified Provider Credentialing Specialist) certification preferred but not required

Orthopaedic Solutions Management is a Drug Free Workplace

We are committed to maintaining a safe, healthy, and productive work environment. As part of this commitment, we operate as a drug-free workplace. All candidates will be required to undergo pre-employment drug screening and/or be subject to random drug testing in accordance with applicable laws and company policy.

Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

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