Credentialing Coordinator

Job Summary

To support the Medical Staff Office, the full-time Credentialing Coordinator will manage the credentialing and privileging process for healthcare practitioners, ensuring compliance with regulatory standards while maintaining accurate and confidential records in a remote work environment.

Key responsibilities

• Processes applications for credentialing and privileging, ensuring compliance with legal and regulatory guidelines
• Organizes and maintains confidential practitioner credential files, conducting follow-ups and primary source verifications as needed
• Maintains computerized credentialing databases, documenting all steps in the credentialing process from application receipt to completion

Required qualifications

• High School Diploma or GED required, with 3 years of medical staff credentialing experience in a healthcare or insurance provider setting; OR
• Associate's degree and 3 years' experience in data collection or analysis using complex database software systems; OR
• A combination of education and experience
• Demonstrated software database experience for generating correspondence and tracking activities
• Familiarity with legal, state, TJC, and NCQA guidelines for medical staff compliance