Credentialing Coordinator

Job Summary

To ensure timely payer credentialing and recredentialing of providers, the full-time Credentialing Coordinator will manage application processing, monitor expiring documents, and conduct primary source verification, all while working remotely.

Key responsibilities

• Coordinates provider credentialing by tracking applications and preparing credential files in compliance with NCQA and CMS regulations
• Performs primary source verification of provider information to meet NCQA and CMS standards
• Engages in discussions with internal and external contacts to relay information regarding credentialing and network participation

Required qualifications

• High School diploma or equivalent with one year of administrative experience, or an Associate's, Bachelor's, or Master's degree in lieu of experience
• Knowledge of NCQA and CMS regulations regarding provider credentialing
• Proficient in Microsoft Office applications, including Excel
• Excellent organizational and prioritization skills
• Ability to adapt to various workloads and work environments