Credentialing Coordinator III

Job Summary

Responsible for completing credentialing functions, the full-time Credentialing Coordinator III will ensure compliance with standards and health plan requirements while maintaining relationships with health plan auditors and physician leaders, working remotely from within California.

Key responsibilities

• Complete credentialing functions and ensure program integrity and compliance with federal and state requirements
• Maintain relationships with health plan auditors and communicate with physician leaders regarding credentialing issues
• Audit Credentialing Verification Organization's files to ensure primary source verification of physician information

Required qualifications

• High School Diploma or General Education Diploma (GED)
• Two years of recent relevant experience in medical provider credentialing
• Knowledge of credentialing and accreditation principles, processes, and documentation
• Proficiency in MS Word, MS Excel, and MS Access, along with data entry skills
• Ability to analyze data and prepare reports based on findings