Help ensure providers are ready to deliver exceptional patient care by supporting credentialing, enrollment, and regulatory compliance across the UF Health Shands system.
Work Style: Onsite, with hybrid flexibility available after six (6) months
Location: Gainesville, FL
FTE: PRN
Schedule: Monday – Friday
Serving as a key liaison between the Medical Staff Office, credentialed providers, and internal stakeholders, this position plays a critical role in maintaining compliance with credentialing, privileging, enrollment, and accreditation requirements.
The Provider Enrollment & Credentialing Specialist is responsible for compiling, reviewing, and analyzing credentialing and provider enrollment documentation to ensure physicians and allied health professionals remain appropriately credentialed and privileged in accordance with statutory, regulatory, and accreditation standards. This role also supports provider enrollment with state and government payers and maintains enrollment records within billing and credentialing databases to ensure accurate reimbursement and uninterrupted provider participation.
Responsibilities:• Acts as a liaison between the Medical Staff Office, credentialed providers, and internal/external stakeholders across the UF Health Shands system.
• Performs credentialing and privileging activities for Medical Staff and Allied Health Professionals in accordance with organizational policies, regulatory requirements, and accreditation standards.
• Compiles, reviews, verifies, and analyzes credentialing and provider enrollment documentation to ensure accuracy, completeness, and compliance.
• Coordinates provider enrollment, revalidation, and maintenance activities with Medicare, Medicaid, and other federal, state, and governmental payers.
• Maintains accurate provider enrollment and credentialing records within billing, credentialing, and provider management systems to support appropriate reimbursement and regulatory compliance.
• Monitors provider licensure, certifications, registrations, and other credentialing requirements to ensure timely renewals and continued compliance.
• Collaborates with physicians, advanced practice providers, department leaders, and external agencies to obtain required documentation and resolve credentialing or enrollment issues.
• Supports audits, accreditation surveys, and compliance reviews by maintaining accurate and complete provider records.
• Tracks credentialing and enrollment deadlines, follow-up activities, and application status to ensure timely completion and uninterrupted provider participation.
• Provides professional customer service and support to providers and stakeholders regarding credentialing, privileging, and enrollment processes.
Qualifications:Education
• Bachelor's degree required; or a minimum of four (4) years of equivalent combination of education and experience, including advanced administrative experience and independent project task management, required.
Experience & Skills
• Strong organizational skills with the ability to prioritize tasks and manage multiple demands effectively.
• Must be detail-oriented and able to work independently on credentialing and provider enrollment projects as assigned.
• Proficiency working in a paperless computer environment, including credentialing software, Microsoft Office Suite, Adobe Acrobat Professional, document scanning/storage systems, and web-based applications and tools.
• Understanding of provider data integrity standards and best practices.
• Knowledge of credentialing, privileging, accreditation standards, provider billing, and enrollment with federal and state programs preferred.
Employees in this position will operate vehicles for an assigned business purpose as a non-frequent driver.
Note: A frequent driver is defined as an employee who uses a personal or Shands vehicle:
• At least once daily; or
• At least five (5) individual trips per week; or
• Drives, on average, more than 150 miles per week in the performance of job duties.
Please indicate the appropriate operator designation on the Request for Personnel (RFP) form at the time the position is submitted for posting.