Credentialing & Provider Relations Clerk
Doral, Florida, 33166, United States
About Leon Health:
Leon Health is a Medicare Advantage plan proudly serving the Miami-Dade community. We are committed to delivering high-quality, culturally competent healthcare to our members. As we grow, we are looking for a dedicated and detail-orientedPhysician Credentialing and Provider Relations Clerkto support our provider network and ensure compliance with credentialing standards.
Position Summary:
This role is responsible for processing credentialing and re-credentialing applications, maintaining accurate provider records, and supporting the Provider Relations team in building and maintaining strong relationships with our physician partners.
Key Responsibilities:
- Process and track initial and re-credentialing applications for physicians and allied health professionals.
- Verify provider credentials including licensure, education, board certifications, and malpractice insurance.
- Maintain and update provider data in credentialing systems (e.g., CAQH, MD-Staff).
- Ensure compliance with CMS, AHCA, and NCQA standards.
- Assist with provider onboarding and orientation.
- Respond to provider inquiries regarding credentialing status and documentation.
- Support Provider Relations with communications, updates, and issue resolution.
Why Join Leon Health?
- Competitive salary and benefits
- Opportunity to grow with a mission-driven organization
- Supportive and inclusive team culture
- Make a meaningful impact in the Miami-Dade healthcare community
Qualifications:
- High school diploma or equivalent required; associate degree or higher preferred.
- 1–2 years of experience in healthcare credentialing or provider relations.
- Familiarity with credentialing databases and systems (e.g., CAQH, MD-Staff).
- Strong attention to detail and organizational skills.
- Excellent communication and interpersonal abilities.
- Bilingual (English/Spanish) preferred.