Medical Credentialing/Provider Enrollment Coordinator

Department: Finance/Accounting

Reports To: Accounting Manager or Controller

FLSA Status: Non-Exempt

JOB SUMMARY

The Medical Credentialing / Provider Enrollment Coordinator is responsible for managing the credentialing, recredentialing, and payer enrollment processes for healthcare providers. This role ensures providers meet all regulatory, accreditation, and payer requirements and are enrolled accurately and timely with insurance plans, hospitals, and other entities. The coordinator plays a critical role in maintaining compliance, minimizing revenue delays, and supporting provider onboarding.

QUALIFICATIONS

• High school diploma or equivalent required; associate’s or bachelor’s degree in healthcare administration or a related field preferred.
• Minimum of 1–3 years of experience in medical credentialing, provider enrollment, or healthcare administration.
• Working knowledge of provider credentialing and payer enrollment processes.
• Familiarity with CAQH, Medicare, Medicaid, and commercial payer enrollment requirements.
• Strong attention to detail and ability to manage multiple applications and deadlines simultaneously.
• Excellent written and verbal communication skills.
• Proficiency in Microsoft Office (Word, Excel, Outlook) and credentialing/enrollment software systems.

JOB FACTORS

Physical Requirements:

• Ability to sit for extended periods while working at a computer
• Ability to perform repetitive hand and finger movements for typing and data entry
• Ability to view a computer screen for prolonged periods
• Ability to occasionally lift up to 10 pounds
• Sufficient vision and hearing to perform job duties.

Mental Requirements:

• Strong attention to detail and accuracy
• Ability to manage multiple tasks and deadlines
• Effective problem-solving and critical-thinking skills
• Ability to interpret and apply payer, regulatory, and organizational requirements
• Ability to maintain confidentiality and exercise sound judgment
• Ability to work independently and collaboratively
• Ability to handle routine job-related stress

Working Conditions:

• Office-based work environment
• Regular use of a computer, telephone, and standard office equipment
• Standard business hours with occasional flexibility to meet deadlines
• Minimal exposure to physical risk
• Frequent interaction with providers, payers, and internal departments

Transportation:

• Reliable transportation to and from the office
• Ability to travel locally as needed for job-related purposes

Essential Functions:

• Coordinate initial credentialing and recredentialing for all providers in accordance with organizational policies, payer requirements, and applicable federal and state regulations.
• Prepare, submit, and track provider enrollment applications for commercial, Medicare, Medicaid, and other payer plans.
• Maintain accurate and up-to-date provider credentialing files, including licenses, certifications, DEA registrations, malpractice insurance, education, and work history.
• Monitor credentialing and enrollment timelines to ensure timely approvals and prevent lapses in participation or billing.
• Communicate with providers, payers, hospitals, and internal departments regarding credentialing status, missing documentation, and approvals.
• Maintain provider data in credentialing and enrollment systems (e.g., CAQH, payer portals, internal databases).
• Track expiration dates and proactively request updated documents to ensure ongoing compliance.
• Assist with audits, surveys, and accreditation reviews by providing credentialing documentation as requested.
• Ensure compliance with HIPAA, NCQA, CMS, and other applicable regulatory and accreditation standards.
• Collaborate with billing, compliance, and operations teams to resolve enrollment or credentialing-related issues that impact reimbursement.
• Perform other related duties as assigned.

Location: In office

Pay: $33.00 - $35.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience:

• medical credentialing: 1 year (Required)

Ability to Commute:

• Oklahoma City, OK 73159 (Required)

Work Location: In person

Salary : $33 - $35