Credentialing Coordinator
New
Based in the United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 1+ year of administrative experience
- Required Skills
- Microsoft ExcelMicrosoft OfficeData entry
Requirements
- High school diploma or equivalent with 1+ year of administrative experience, or associate/bachelor’s/master’s degree in lieu of experience
- Knowledge of NCQA and CMS credentialing regulations
- Strong organizational and prioritization skills with the ability to manage multiple tasks
- High attention to detail and strong accuracy in data entry and documentation
- Proficiency in Microsoft Office, including Excel, and general computer systems
- Strong written and verbal communication skills in a professional environment
- Ability to work effectively in a fast-paced, deadline-driven setting
- Comfortable handling repetitive administrative tasks with sustained focus and accuracy
- Ability to adapt to changing workloads and operational priorities
Responsibilities
- Coordinate provider credentialing and recredentialing workflows, including application tracking and data entry into credentialing systems
- Perform primary source verification of provider credentials in compliance with NCQA and CMS standards
- Monitor expiring documents, sanctions, and compliance requirements to ensure continuous credentialing validity
- Review credentialing applications and request missing or incomplete information as needed
- Prepare and maintain credentialing files for review and audit readiness
- Communicate with internal teams and external providers to resolve credentialing-related inquiries and updates
- Maintain working knowledge of evolving NCQA and CMS credentialing standards
- Support special projects and operational initiatives as assigned by supervision
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