Credentialing Coordinator

Job Summary

To support the credentialing process within a leading healthcare system, the full-time remote Credentialing Coordinator I will process, review, and maintain provider and facility credentialing files while ensuring compliance with state and NCQA requirements.

Key responsibilities

• Enters and updates provider and facility data in the credentialing database while adhering to standards
• Coordinates the processing of initial and re-credentialing applications within established turnaround times
• Conducts verification of credentialing elements and maintains ongoing monitoring and sanctions reporting

Required qualifications

• Associate's Degree preferred
• 1-2 years of experience in Clinical/Medical Office/Healthcare required
• 2-3 years of previous credentialing experience, with at least 1 year in a health insurance environment, highly preferred
• Experience with OneCare and/or SCO highly preferred
• Knowledge of medical provider credentialing and accreditation principles