Description

Credentialing Coordinator

Reports to: Credentialing Specialist

Summary: 

Process credentialing and re-credentialing applications of health care providers. 

Responsibilities: 

• Review application, prepare verification letters and maintain database.
• Contact medical office staff, licensing agencies, and insurance carriers to complete credentialing and re-credentialing applications.
• Complete administrative duties, such as ensuring state medical licenses are up-to-date and checking the status of new license applications. 
• Documentation skills. 
• Other responsibilities as assigned. 

Requirements

Essential Job Functions: 

• Maintains collaborative relationships with insurance representatives and billing. 
• Manage care department offices and maintain strong relationships with existing and new outreach partnering medical offices to facilitate credentialing processes. 
• Performs Administrative job duties within the scope of the non-lead/non-supervisory job classification to establish and maintain the integrity of the credentialing and privileging operations.
• Other job functions as assigned. 

Knowledge, Skills, and Abilities:

• High School Diploma required.
• Knowledge of credentialing and privileging preferred. 
• Extensive knowledge and experience working with Microsoft applications such as Microsoft Word, Excel, Access, PowerPoint, and Visio with the ability to operate standard office equipment.
• Well-developed interpersonal skills, including the ability to deal effectively with all levels of personnel, both within and in a group.
•  Excellent problem-solving and decision-making skills.
• Ability to effectively manage competing priorities and deadlines with minimal supervision.

Education:

• High School Diploma equivalency OR 1 year of applicable cumulative job specific experience required. 

Additional Preferences:

Experience:

• Prior Experience preferred.