Credentialing Coordinator

Job Summary

Working remotely on a full-time basis, the Credentialing Coordinator will manage the credentialing, privileging, and primary source verification processes for medical and allied health professionals, ensuring compliance with regulatory standards while collaborating with various departments to enhance practitioner quality and patient safety.

Key responsibilities

• Determines practitioner eligibility by analyzing applications and conducting thorough background investigations to validate credentials
• Monitors the initial and reappointment processes for medical staff, ensuring timely compliance with regulatory requirements
• Collaborates with key stakeholders to communicate the status of applicant files and expiring credentials, facilitating timely documentation and compliance

Required qualifications

• Associate's degree in business or a healthcare-related field and 2 years of medical administrative experience required
• 1 year of medical credentialing and/or payer enrollment experience preferred
• Knowledge of Joint Commission, CMS, and NCQA Regulations related to medical staff services preferred
• Proficiency in MS Office applications required
• Certified Medical Professional Services Management (CPMSM) or Certified Provider Credentialing Specialist (CPCS) preferred upon hire