Credentialing Coordinator

Job Summary

Credentialing Coordinator is a full-time position responsible for ensuring compliance with credentialing activities according to URAC, NCQA, and regulatory standards while managing provider applications and re-credentialing processes.

Key Responsibilities

• Ensure compliance with credentialing standards and regulations
• Perform Primary and Secondary Source Verification for providers and maintain accurate provider files
• Coordinate with various departments to complete credentialing applications and respond to inquiries

Required Qualifications

• High School Diploma or equivalent
• Minimum of one year of credentialing experience or knowledge
• Intermediate computer skills and proficiency in Microsoft Word and Excel
• Knowledge of URAC and NCQA accreditation standards
• Familiarity with healthcare terminology and Medicaid & Medicare managed care