Credentialing Coordinator

Overview

We are seeking a Credentialing Coordinator to join our Provider Services team. This individual will be responsible for coordinating and maintaining provider credentialing processes, ensuring compliance with policies and procedures, and supporting providers in understanding credentialing requirements. The role involves handling confidential documentation, performing verifications, and maintaining accurate provider records.

Base pay range

$25.00/hr - $32.00/hr

• Maintain communication with credentialing contacts at provider sites to coordinate receipt of information for credentialing, re-credentialing, and updates.
• Review provider credentialing files for completion and prepare them for presentation to the Credentialing Committee.
• Perform primary source verifications in accordance with organizational policies and procedures.
• Enter and update provider information in the credentialing database.
• Verify state and federal databases for sanctions, licensure restrictions, or scope of practice limitations.
• Generate and distribute monthly provider credentialing updates to relevant departments and providers.
• Create, file, and maintain all credentialing documentation in provider folders.
• Conduct annual delegated file audits and participate in pre-delegation and delegation site reviews.
• Respond to inquiries from internal departments regarding provider credentialing status.
• Perform other related tasks as directed by leadership.

• Excellent communication and organizational skills
• Previous experience with provider credentialing processes and procedures required
• Knowledge of credentialing policies and procedures preferred
• Proficiency in Microsoft Office; knowledge of credentialing software (such as CACTUS) preferred

• High School diploma or equivalent required

• Seniority level:
  Associate
• Employment type:
  
  Contract
• Job function:
  Administrative, Accounting/Auditing, and Finance
• Industries:
  Hospitals and Health Care and Health and Human Services

Note:

This listing includes standard disclaimers about pay ranges and referral information as part of the job posting.