Credentialing Coordinator

Pride Health; New York (NY); On-site; USD 34,440 - 44,083; Full time

Job summary

A healthcare provider in New York seeks a Credentialing Coordinator for its Provider Services team. The role involves coordinating provider credentialing processes, ensuring compliance with policies, and assisting providers with credentialing requirements. Candidates should possess excellent communication skills and previous experience in credentialing. This is a contract position with a salary range of $25-$32 per hour.

Qualifications

• Strong background in provider credentialing processes.
• Ability to handle confidential information responsibly.
• Capable of performing verifications accurately.

Responsibilities

• Coordinate receipt of information for credentialing and updates.
• Review credentialing files for completion.
• Perform primary source verifications as per policies.
• Update provider information in the credentialing database.
• Verify state and federal databases for sanctions.

Skills

Excellent communication and organizational skills

Previous experience with provider credentialing processes

Knowledge of credentialing policies and procedures

Proficiency in Microsoft Office

Knowledge of credentialing software (e.g. CACTUS)

Education

High School diploma or equivalent

Tools

Microsoft Office

CACTUS

Job description

Overview

We are seeking a Credentialing Coordinator to join our Provider Services team. This individual will be responsible for coordinating and maintaining provider credentialing processes, ensuring compliance with policies and procedures, and supporting providers in understanding credentialing requirements. The role involves handling confidential documentation, performing verifications, and maintaining accurate provider records.

Base pay range

$25.00/hr - $32.00/hr

Key Responsibilities

• Maintain communication with credentialing contacts at provider sites to coordinate receipt of information for credentialing, re-credentialing, and updates.
• Review provider credentialing files for completion and prepare them for presentation to the Credentialing Committee.
• Perform primary source verifications in accordance with organizational policies and procedures.
• Enter and update provider information in the credentialing database.
• Verify state and federal databases for sanctions, licensure restrictions, or scope of practice limitations.
• Generate and distribute monthly provider credentialing updates to relevant departments and providers.
• Create, file, and maintain all credentialing documentation in provider folders.
• Conduct annual delegated file audits and participate in pre-delegation and delegation site reviews.
• Respond to inquiries from internal departments regarding provider credentialing status.
• Perform other related tasks as directed by leadership.

Qualifications

• Excellent communication and organizational skills
• Previous experience with provider credentialing processes and procedures required
• Knowledge of credentialing policies and procedures preferred
• Proficiency in Microsoft Office; knowledge of credentialing software (such as CACTUS) preferred

Education

• High School diploma or equivalent required

Additional details

• Seniority level: Associate
• Employment type: Contract
• Job function: Administrative, Accounting/Auditing, and Finance
• Industries: Hospitals and Health Care and Health and Human Services

Note: This listing includes standard disclaimers about pay ranges and referral information as part of the job posting.