Credentialing Coordinator III

Job Summary

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

Key responsibilities:

• Determines practitioner eligibility and analyzes application documents for accuracy and completeness, conducting thorough background investigations and primary source verifications
• Monitors the initial and reappointment processes for medical staff, ensuring timely processing and compliance with regulatory requirements
• Collaborates with key stakeholders and communicates the status of applicant files and expiring credentials to ensure all policies and standards are met

Required qualifications:

• Associate's degree in business or 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