Credentialing Coordinator

Job Summary

A company is looking for a Credentialing Coordinator III.

Key Responsibilities

• Determines practitioner eligibility for membership and analyzes application documents for accuracy
• Obtains and evaluates information from primary sources to ensure compliance with accreditation standards
• Monitors the credentialing process and communicates status updates to stakeholders

Required Qualifications

• Associate's degree in business or healthcare related field and 2 years of medical administrative experience required
• Equivalent combination of education and experience may be considered
• 1 year of medical credentialing and/or payer enrollment experience preferred
• Knowledge of Joint Commission, CMS, and NCQA Regulations preferred
• Certified Medical Professional Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred upon hire