Credentialing Coordinator

The Center for Cancer and Blood Disorders; Fort Worth (TX); On-site; USD 45,000 - 60,000; Full time

Benefits offered by this job

401(k)

Dental insurance

Health insurance

Vision insurance

Paid time off

Job summary

The Center for Cancer and Blood Disorders in Fort Worth is hiring a full-time Credentialing Coordinator. The role focuses on managing the credentialing and re-credentialing of healthcare professionals, enhancing the quality of cancer patient care. Ideal candidates should have at least 2 years of experience in credentialing and proficiency in Microsoft Office.

Join our dedicated team that offers various benefits including health insurance, 401(k), and paid time off.

Qualifications

• Minimum of two (2) years’ credentialing experience with a large provider practice or hospital system.
• Proficiency with computer systems and Microsoft Office (Word & Excel) required.

Responsibilities

• Ensure accurate completion of all credentialing applications.
• Collect primary source verification documentation for credentialing.
• Maintain credentialing database and provider credentialing files.

Skills

Credentialing experience

Verbal and written communication

Microsoft Office proficiency

Education

High school diploma or equivalent

Job description

At The Center for Cancer and Blood Disorders, our board-certified physicians provide cancer treatment to more than 12,000 patients annually at our locations in Fort Worth – Central Campus, Fort Worth – Southwest, Arlington, Burleson, Dallas, Denton, Gainesville, Granbury, Las Colinas, Mansfield, Mineral Wells, Plano, Southlake, Stephenville, and Weatherford. We offer you the latest advances in chemotherapy, radiation therapy, immunotherapy, hormonal therapy, and biological therapy. We also offer you the opportunity to take advantage of groundbreaking cancer treatment available only through clinical trials and cancer research.

Why Join Us? We are looking for talented and highly‑motivated individuals who demonstrate a natural desire to support the meaningful work of community oncologists and the patients we serve.

Job Description

Job Type: Full‑Time

Position: Credentialing Coordinator

Reports to: Contracting Manager

Full Job Description

The Center for Cancer and Blood Disorders provides cancer treatment to patients throughout N. Texas. We are looking for talented and highly motivated individuals to support the meaningful work of caring for cancer patients. We provide opportunities for professional growth and development. Our employees are our greatest asset! Come join our team! We are seeking a Full‑time Credentialing Coordinator for our Fort Worth office.

Scope

The Credentialing Coordinator will report to the Contracting Manager. The Credentialing Coordinator is responsible for all aspects of the credentialing and re‑credentialing of health care professionals, including payer enrollment, hospital privileging and licensing. The coordinator will process payor and hospital applications in accordance with medical staff and payor procedures. The coordinator will work collaboratively with other internal departments to troubleshoot out of network payer issues and other payer‑related enrollment discrepancies. Work includes accurate, timely and documented verification of information and maintenance of provider credentialing files.

Essential Duties and Responsibilities

• Ensure accurate and timely completion, submission, and follow‑up on all outstanding credentialing/re‑credentialing applications with payers and hospitals.
• Collect primary source verification documentation for initial credentialing, including licensing, board certifications, proof of professional liability insurance, and other necessary documents.
• Establish and maintain positive working relationships with payer representatives, hospital medical staff, internal departments, and providers.
• Maintain credentialing database and ensure information is up to date at all times.
• Notify staff upon completion of provider credentialing and plan participation status for scheduling and billing purposes.
• Prepare and maintain Texas Standardized Credentialing Application (TSCA), CAQH, and Availity for all providers.
• Complete NPPES (NPI), PECOS (CMS) and Texas Medicaid applications.
• Verify that all credentialing requirements are met.
• Work with the billing department to resolve provider enrollment issues resulting in claim rejections/denials.
• Responsible for monthly submission of provider roster to health plans and timely communication of group additions, changes, and terminations.
• Stay abreast of regulatory requirements.
• Track continuing education credits for all providers.
• Adhere to HIPAA privacy regulations.
• Perform other duties as assigned.

Key Competencies

• Recent credentialing experience.
• Experience in both group and individual provider credentialing.
• Experience in credentialing of major payers such as Medicare, Medicaid, Tricare, BCBS, Aetna, Cigna, Humana, and other commercial and managed plans.
• Knowledge of state and payer specific guidelines.
• Experience in creating CAQH, NPI, and PECOS profiles and applications.
• Detail oriented and capable of exploring innovative solutions to solve complex problems.
• Ability to work independently and maintain a positive attitude.
• Ability to manage multiple and simultaneous responsibilities.
• Ability to maintain confidentiality of all medical, financial, and legal information.
• Ability to complete work assignments accurately and in a timely manner.
• Ability to communicate effectively, with excellent verbal and written communication and customer relation skills.
• Strong organizational skills.

Qualifications

• Minimum of two (2) years’ credentialing experience with a large provider practice or hospital system.
• Proficiency with computer systems and Microsoft Office (Word & Excel) required.

Physical Demands

Requires sitting and standing associated with a normal office environment.

Work Environment

Primarily clinic or office setting.

Benefits

• 401(k)
• AD&D insurance
• Dental insurance
• Disability insurance
• Flexible spending account
• Free parking
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Experience

Credentialing: 2 years (Required)

Microsoft Word: 1 year (Required)

Work Location: In person