Referral coordinator/ credentialing assistant

Job Summary
We are seeking a proactive and detail-oriented Referral Coordinator/Credentialing Assistant to join our dynamic healthcare team. In this vital role, you will serve as the primary point of contact for managing referral processes and ensuring provider credentialing aligns with industry standards. Your efforts will directly contribute to seamless patient care coordination, compliance with regulatory standards, and the smooth operation of our medical services. This position offers an exciting opportunity to work in a fast-paced environment where your organizational skills and healthcare knowledge will make a meaningful impact. Hours M- F 730a- 430pm

Responsibilities

• Facilitate patient referrals by coordinating communication between providers, patients, and insurance companies to ensure timely and accurate processing.
• Manage provider credentialing and re-credentialing processes in accordance with NCQA (National Committee for Quality Assurance) standards, maintaining up-to-date documentation.
• Maintain detailed records of credentialing activities, referral logs, and correspondence to ensure compliance and audit readiness.
• Collaborate with medical offices to gather necessary documentation, resolve credentialing issues, and streamline workflows.
• Assist in monitoring adherence to NCQA standards and other regulatory guidelines to uphold quality assurance protocols.
• Support administrative tasks such as data entry, report generation, and scheduling related to referrals and credentialing activities.

Requirements

• Proven experience working in a medical office setting or healthcare environment with a strong understanding of medical terminology.
• Familiarity with managed care processes, insurance verification, and prior authorization procedures.
• Prior experience with provider credentialing or related administrative functions is highly preferred.
• Excellent organizational skills with keen attention to detail to manage multiple tasks efficiently.
• Strong communication skills to liaise effectively with providers, insurance companies, and internal teams.
• Knowledge of NCQA standards or similar accreditation requirements is a plus.
• Ability to adapt quickly in a fast-paced environment while maintaining accuracy and professionalism. Join us in delivering exceptional healthcare coordination that enhances patient experiences and supports our mission of quality care!

Pay: $16.00 - $18.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Paid time off

Experience:

• referrals: 1 year (Preferred)
• credentialing: 1 year (Preferred)

Work Location: In person

Salary : $16 - $18