Network Data Specialist- Credentialing Team

Job Description

Job Description

Join Our Growing Healthcare Team!

Are you a highly organized, detail-oriented professional who enjoys working with data, healthcare operations, and provider relations? Florida Doctors Group is looking for a Network Data Specialist to join our growing team.

In this role, you will play a critical part in maintaining the integrity of our provider network by supporting credentialing, provider data management, contracting, and health plan enrollment activities. You'll work closely with insurance companies, healthcare providers, and internal departments to ensure our providers remain compliant, accurately represented, and ready to serve our members.

This is an excellent opportunity for someone who enjoys problem-solving, managing multiple projects, and contributing to a fast-paced healthcare organization that values teamwork, accuracy, and professional growth.

What You'll Do

As a Network Data Specialist, you will:

• Coordinate provider and facility credentialing with multiple commercial and government health plans. 
• Complete and submit provider and facility credentialing and contracting applications. 
• Perform primary source verification of provider credentials, including: 
  • State Licenses 
  • DEA Registrations 
  • Board Certifications 
  • Malpractice Insurance 
  • Professional Liability History 
  • Sanction Monitoring 
  • Education and Training Verification 
• Maintain accurate provider demographic, credentialing, and contracting information across internal databases and health plan portals. 
• Monitor license, certification, DEA, malpractice, and other credential expiration dates to ensure continuous compliance. 
• Update provider records and practice information with health plans and regulatory agencies. 
• Audit provider directories to ensure information remains current and accurate. 
• Research and resolve provider data discrepancies with insurance companies and internal departments. 
• Collaborate with Provider Relations, Contracting, Quality, Billing, and Operations teams to resolve provider issues. 
• Assist with provider onboarding and network maintenance initiatives. 
• Maintain accurate documentation and tracking throughout the credentialing lifecycle. 
• Participate in special projects and other duties as assigned.

The ideal candidate possesses:

• Strong attention to detail and exceptional organizational skills. 
• Ability to prioritize multiple projects while meeting deadlines. 
• Strong analytical and problem-solving abilities. 
• Excellent verbal and written communication skills. 
• Ability to work independently while collaborating effectively with multiple departments. 
• Professionalism when communicating with physicians, office managers, insurance representatives, and leadership. 
• Proficiency with Microsoft Office (Excel, Outlook, Word, Teams). 
• Experience working with online health plan portals and provider databases is preferred. 
• Knowledge of CAQH, NPPES, PECOS, and provider enrollment systems is a plus. 
• Understanding of healthcare credentialing, provider enrollment, contracting, or provider data management is preferred. 

Preferred Qualifications

• 1-3 years of experience in healthcare administration, provider credentialing, provider enrollment, medical office administration, health plan operations, or provider data management. 
• Experience working with Medicare Advantage, Medicaid, Commercial, or Marketplace health plans is highly desirable. 
• Associate's or Bachelor's degree preferred, but equivalent experience will also be considered. 

Why Join Florida Doctors Group?

At Florida Doctors Group, you'll become part of a collaborative organization dedicated to supporting physicians and improving healthcare delivery throughout Florida. We invest in our employees by providing opportunities for professional growth, continuous learning, and career advancement while fostering a supportive and team-oriented work environment.

If you're looking for a career where your work directly impacts healthcare providers and the patients they serve, we'd love to hear from you.