Credentialing Coordinator

Job Summary

To ensure a high-quality provider network, the full-time Credentialing Coordinator will manage credentialing activities, including processing and tracking credentialing files, primary source verification, and liaising with providers and regulatory agencies in a remote setting.

Key responsibilities

• Process and track credentialing files, ensuring timely completion and accuracy of provider information
• Coordinate onboarding of new providers for payer enrollment and medical staff privileges
• Maintain confidential credentialing files and electronic databases, ensuring compliance with regulatory standards

Required qualifications

• High school graduate or GED equivalent; an associate degree is preferred
• Minimum of 2 years of experience in payer credentialing, provider billing services, or health clinic customer service
• Knowledge of managed healthcare industry and regulatory agency standards (e.g., NCQA, URAQ)
• Proficient in Microsoft Office Suite and database management
• CPCS Certification is preferred