Credentialing Coordinator

The Credentialing Coordinator is responsible for processing and completing the credentialing and recredentialing functions of all providers in accordance with NCQA, state, and federal requirements.

Principal Accountabilities:

·Validates completeness of provider applications prior to processing.

·Conducts primary source verification for all credentialing and recredentialing applications.

·Monitors the progress and completion of all site visits by the provider network team to ensure completion within established timeframe.

·Accurately enters all critical data elements of provider applications into Credentialing system.

·Responds to phone inquiries received into the Credentialing phone queue from internal and external clients.

·Completes projects as assigned.

Requirements:

·0-4 years of prior provider credentialing experience based on a combination of education and experience.

·High School/GED with 4 years of experience.

·Associate’s Degree with 1-2 years of experience.

·Bachelor’s Degree with 0-1 years of experience.

·Intermediate knowledge of PC applications, including Microsoft Office.

·Strong verbal and written communication skills.

·Strong organizational skills required.

·Ability to perform in a metrics-driven environment.

If you are not interested in looking at new opportunities at this time I fully understand. I would in that case be appreciative of any referrals you could provide from your network of friends and colleagues in the industry. We do offer a referral bonus that I’d be happy to extend to you if they turn out to be a great fit for my client.