Credentialing Coordinator, Connecticut

Job Summary

Coordinating the timely and accurate credentialing of providers, the full-time Credentialing Coordinator in Connecticut will manage applications for commercial carriers and assist with Medicaid and Medicare enrollment processes while working remotely.

Key responsibilities

• Coordinates the review of credentialing applications and monitors data accuracy to ensure timely processing
• Assists with Medicaid and Medicare enrollment processes, including researching denials and re-enrolling providers
• Maintains effective communication with clinical practice managers and insurance carriers to facilitate credentialing application processing

Required qualifications

• Eight years of related work experience, with at least six years in a similar role or relevant education qualifications
• Comprehensive knowledge of medical credentialing and provider enrollment processes for managed care and government programs
• Strong grasp of regulatory standards and payer systems related to Medicaid and Medicare
• Proficient in Microsoft Word, Access, and Excel, with strong organizational and customer service skills
• Ability to handle multiple assignments and work under pressure while maintaining confidentiality