Credentialing Coordinator III

Job Summary

A company is looking for a Credentialing Coordinator III to manage the credentialing and privileging processes for medical and allied health professionals.

Key Responsibilities

• Determine practitioner eligibility and analyze application documents for accuracy
• Conduct primary source verification and background investigations for credentialing compliance
• Communicate with applicants and stakeholders regarding application statuses and expiring credentials

Required Qualifications

• Associate's degree in business or healthcare-related field and 2 years of medical administrative experience
• Equivalent combination of education and experience may be considered
• 1 year of medical credentialing and/or payer enrollment experience preferred
• Certification as a Medical Professional Services Manager (CPMSM) or Provider Credentialing Specialist (CPCS) preferred
• Knowledge of Joint Commission, CMS, and NCQA regulations related to medical staff services preferred