Credentialing Quality Assurance Coordinator

Job Summary

Ensuring compliance and quality assurance for delegated credentialing processes, the full-time Credentialing Quality Assurance Coordinator will review provider documentation, conduct audits, and develop training materials while working remotely from anywhere in the U.S.

Key responsibilities

• Review BCBA and related provider packets for completeness and accuracy, ensuring primary source verification
• Conduct routine and ad hoc audits of delegated credentialing files to maintain compliance with regulatory standards
• Collaborate with the Credentialing team to develop and deliver training materials for internal staff and delegated entities

Required qualifications

• Experience in credentialing processes, particularly for behavioral health providers
• Knowledge of regulatory standards, including NCQA and CMS requirements
• Proficiency in creating and maintaining audit tools and reporting dashboards
• Ability to develop and deliver training materials effectively
• Strong organizational skills to monitor delegated entities and ensure compliance