Credentialing Coordinator

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Requirements:

• Bachelor’s Degree preferred.
• Minimum of two (2) years of credentialing experience.
• Working knowledge of credentialing accreditation regulations, policies and procedures, and NCQA standards.
• Exceptional communication skills, both written and verbal.
• Strong attention to detail and self-starter mentality.
• Ability to plan, prioritize, and meet deadlines.
• Excellent computer skills including Excel, Word, Google Suite, and Internet usage.

Responsibilities:

• Partner with the Credentialing Manager and third-party service providers to ensure compliance and documentation of providers' credentials.
• Manage support issues through ZenDesk and develop processes for better provider experience.
• Coordinate with external credentialing verification organizations for timely application processing.
• Audit compliance with NCQA and state-level requirements.
• Oversee agreement workflows with contracted providers and maintain data integrity.
• Perform employment verifications and send out certificates of insurance.
• Collaborate with the Provider Success team for streamlined onboarding processes.
• Work externally with third-party service providers to improve efficiencies in credentialing processes.
• Assist the Credentialing Manager in recommending improvements and building the credentialing program.