Coordinator, Credentialing
New
J
JobgetherHealthcare credentialing
Based in the United StatesFull-TimeMiddle
Salary18.2 - 29.7 USD per hour
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Job Details
- Experience
- At least 3 years of experience in healthcare credentialing, payer enrollment, managed care administration, or a related provider operations environment.
- Required Skills
- Microsoft Excel
Requirements
- At least 3 years of experience in healthcare credentialing, payer enrollment, managed care administration, or a related provider operations environment.
- Familiarity with insurance payer requirements, provider enrollment procedures, credentialing standards, and common payer-related issues.
- Experience with credentialing databases or management platforms is preferred, including IntelliCred, E-Vips, Vistar, Cactus, or Symed.
- Working knowledge of provider and facility licensing, certification tracking, re-credentialing, and hospital privileging processes.
- Proficiency in Microsoft Excel and Word.
- Strong attention to detail and ability to maintain accurate records, monitor expiration dates, and manage multiple documentation requirements.
- Strong organizational and time management skills, including prioritizing assignments and tracking deadlines.
- Ability to work independently and collaborate with team members and supervisors.
- Ability to recognize discrepancies, follow policies, seek guidance, and escalate complex issues appropriately.
- A college degree in healthcare administration, business, or a related field is preferred; equivalent relevant experience may be considered.
- Flexibility to work additional hours, including overtime and weekends, when operational requirements necessitate it.
- Commitment to confidentiality, data integrity, and compliance in a healthcare environment.
Responsibilities
- Coordinate initial provider enrollment, re-enrollment, credentialing, and re-credentialing activities for healthcare providers and medical groups.
- Document and track credentialing, enrollment, re-credentialing, and hospital privileging activities in the credentialing management platform.
- Monitor provider and facility licenses, certifications, and other required credentials for accuracy, currency, and compliance.
- Coordinate enrollment with contracted insurance payers and monitor provider participation status.
- Prepare and submit hospital privileges applications for physicians, gathering supporting documentation as needed.
- Maintain accurate credentialing records and supporting documentation for verification and reporting.
- Monitor processing timelines, follow up on outstanding requirements, and meet credentialing and enrollment deadlines.
- Communicate progress and outstanding items to the Credentialing Supervisor and team members.
- Use spreadsheets, credentialing databases, and office applications to maintain records and support operational reporting.
- Identify documentation gaps, expired credentials, and potential compliance issues; escalate complex matters to a supervisor.
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