Credentialing Coordinator

University of Oklahoma; Oklahoma City (OK); On-site; USD 44,000; Full time

Job summary

A public educational institution in Oklahoma City is looking for a Credentialing Coordinator to manage credentialing processes for healthcare providers. The role requires an Associate's degree and at least 24 months of relevant healthcare experience. The position is full-time, onsite, with a target salary of $43,800, dependent on experience. The ideal candidate will possess excellent communication skills and knowledge of credentialing standards.

Benefits

Comprehensive benefits package

Qualifications

• Associate's degree or equivalent experience required.
• 24 months healthcare experience in credentialing or related fields is necessary.

Responsibilities

• Coordinate credentialing activities for providers.
• Maintain credentialing files and status databases.
• Ensure compliance with NCQA standards.

Skills

Knowledge of NCQA and AAAHC credentialing standards

Knowledge of Medicare and Medicaid credentialing regulations

Ability to identify problems and discuss with supervisor

Ability to multitask and complete assignments in a timely manner

Ability to work independently and as a team player

Excellent communication skills

Education

Associate's degree

24 months related healthcare experience

Job description

Overview

Job Description - Credentialing Coordinator (251458)

Job Number: Credentialing Coordinator - 251458

Job Details

Schedule: Full-time

Work Schedule: Monday-Friday 8:00 AM-5:00 PM

Work Type: Onsite

Salary Range: Target of salary of $43,800.00 dependent on experience

Benefits Provided: Yes

Required Attachments: Resume

Responsibilities

• Responsible for all aspects of credentialing for providers, to include coordinating delegated and non-delegated credentialing activities, collecting credentialing information from providers, performing necessary queries and background checks on physicians, developing and maintaining credentialing files, performing credentialing activities necessary to maintain accreditation, and coordinating with insurance companies and third party payers concerning credentialing.
• Initiates and processes provider applications for new providers for the purpose of credentialing and re-credentialing. Performs inquiries from the National Practitioner Data Bank, State Medical Board and other entities for the credentialing process.
• Develops an understanding of NCQA and AAAHC credentialing standards, Medicare and Medicaid credentialing regulations, and commercial insurance credentialing requirements. Participates in accreditation activities and development of credentialing policies and procedures.
• Develops an understanding of credentialing processes used by provider services contracts and assists with expediting the process. May coordinate third party credentialing site visits as necessary. Coordinates third party credentialing delegation contracting processes.
• Provides credentialing information to IT department, electronic billing vendors, and any other parties to ensure claims can be sent by the IDX information system.
• Establishes and maintains effective lines of communication with each provider, departments, and clinics. Provides credentialing information to the billing offices and medical departments in the submission and resubmissions of claims.
• Maintains current files for all providers and ensures provider files meet NCQA and delegated provider requirements.
• Maintains a central database showing the current credentialing status for each provider for all provider services contracts.
• Participates in medical group committees and teams. May assist with coordinating the Credentialing Committee and Credentialing Liaison Committee meetings.
• Performs various duties as needed to successfully fulfill the function of the position.

Qualifications

Required Education: Associate's degree. AND:

• 24 months healthcare experience in credentialing, quality assurance, risk management, medical billing or directly related healthcare experience.

Equivalency/Substitution: Will accept 24 months related experience in lieu of the Associate's degree for a total of 48 months related experience.

Skills:

• Knowledge of NCQA and AAAHC credentialing standards
• Knowledge of Medicare and Medicaid credentialing regulations and commercial insurance credentialing.
• Ability to identify problems and discuss with supervisor
• Ability to multitask and complete assignments in a timely manner.
• Ability to work independently and as a team player.
• Excellent communication skills.

Certifications: None

Working Conditions

• Physical:
  • Sit for prolonged periods.
  • Communicate effectively and listen.
  • Use of a computer and calculator.
• Environmental:
  • Standard Office Environment.
  • Contact with departments, faculty, and outside entities.

Additional Information

Equal Employment Opportunity Statement: The University, in compliance with all applicable federal and state laws and regulations, does not discriminate on the basis of race, color, national origin, sex, sexual orientation, marital status, genetic information, gender identity/expression (consistent with applicable law), age (40 or older), religion, disability, political beliefs, or status as a veteran in any of its policies, practices, or procedures. This includes but is not limited to admissions, employment, housing, financial aid, and educational services.

Hiring Contingent Upon: Background Check – Yes

Job Posting: Jul 10, 2025

Important Information

Required Attachments: Documents required for this position are listed under the "Required Attachments" section of this job listing. You will be required to upload and attach these documents in the application process.

Note: ALL required documents must be attached to your job application or your documents will not be visible to the hiring department!