Credentialing Coordinator

Park Duvalle Community Health; South Parkland (KY); On-site; USD 52,000 - 64,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

Life insurance

403(b) employer match

Paid time off

Eleven paid holidays

Predictable schedule

Job summary

Park DuValle Community Health Center is seeking a Credentialing Coordinator to serve as the primary liaison between our organization and an external credentialing partner. This role monitors provider enrollment status, tracks re‑credentialing deadlines, and uses our EMR to keep enrollment data accurate.

You will collaborate with Revenue Cycle, Finance, and Human Resources to resolve payer issues, collect onboarding documents, and maintain organized credentialing files.

Qualifications

• Associate's degree in healthcare administration or related field.
• At least 2 years of healthcare administration, provider enrollment, credentialing support, or billing experience.
• Experience with healthcare providers, credentialing vendors, or payer organizations.
• Familiarity with credentialing and enrollment processes.

Responsibilities

• Serve as the primary liaison between Park DuValle Community Health Center and an external credentialing vendor regarding credentialing and enrollment activities.
• Coordinate the collection of required documentation for provider payor enrollment (Medicaid, Medicare, etc.) and revalidation requests.
• Track the status of provider payor enrollment and revalidation applications submitted by the credentialing vendor and maintain accurate records.
• Maintain organized credentialing and payor enrollment files, including application status, supporting documentation, and payer correspondence.
• Communicate provider updates to include practice location changes, reassignment of benefits, and other required information to the credentialing vendor.
• Follow up with the credentialing vendor and payers regarding outstanding documentation, application status, or processing delays.
• Update provider information within the electronic medical record (EMR) and other internal systems as needed.
• Collaborate with Human Resources to ensure collection of onboarding documentation required for provider credentialing and payor enrollment.
• Support resolution of credentialing denials, requests for additional information, and revalidation requirements by coordinating with the credentialing vendor and internal departments.
• Monitor credentialing timelines and help ensure required documentation and renewals are completed on schedule.
• Prepare routine reports and maintain accurate records related to provider credentialing and enrollment activities.
• Perform other related duties as assigned.

Skills

Credentialing processes

CAQH exposure

Organizational skills

Written and verbal communication

Attention to detail

Microsoft Office Suite

EMR systems proficiency

Interpersonal collaboration

Customer service mindset

Education

Associate's degree in healthcare administration or related field

Tools

CAQH

Payer portals

EMR systems

Job description

Description

We are seeking a Credentialing Coordinator to serve as the primary liaison between our organization and an external credentialing partner. While the majority of the initial credentialing process will be managed by the third‑party credentialing company, this role will monitor progress and ensure compliance with requirements, maintain provider records, and coordinate communication among stakeholders.

Position Summary

The Credentialing Coordinator will be responsible for monitoring provider enrollment status, tracking re‑credentialing deadlines, and utilizing our electronic medical record system to manage and update provider enrollment information. This role will also work closely with our Revenue Cycle and Finance Team to investigate and resolve payer‑related claim denials, identify enrollment issues impacting reimbursement, and assist with corrective actions to prevent gaps in reimbursement.

Position Responsibilities

• Serve as the primary liaison between Park DuValle Community Health Center and an external credentialing vendor regarding credentialing and enrollment activities.
• Coordinate the collection of required documentation for provider payor enrollment (Medicaid, Medicare, etc.) and revalidation requests.
• Track the status of provider payor enrollment and revalidation applications submitted by the credentialing vendor and maintain accurate records.
• Maintain organized credentialing and payor enrollment files, including application status, supporting documentation, and payer correspondence.
• Communicate provider updates to include practice location changes, reassignment of benefits, and other required information to the credentialing vendor.
• Follow up with the credentialing vendor and payers regarding outstanding documentation, application status, or processing delays.
• Update provider information within the electronic medical record (EMR) and other internal systems as needed.
• Collaborate with Human Resources to ensure collection of onboarding documentation required for provider credentialing and payor enrollment.
• Support resolution of credentialing denials, requests for additional information, and revalidation requirements by coordinating with the credentialing vendor and internal departments.
• Monitor credentialing timelines and help ensure required documentation and renewals are completed on schedule.
• Prepare routine reports and maintain accurate records related to provider credentialing and enrollment activities.
• Perform other related duties as assigned.

Benefits & Perks

We offer a competitive and comprehensive benefits package designed to support your health, financial well‑being, and professional growth.

• Medical, dental, vision, and life insurance
• Voluntary benefits, including short‑term disability
• 403(b) retirement plan with employer match up to 5%
• Paid Time Off (PTO)
• Eleven paid holidays
• Predictable work schedule
• Opportunity to serve diverse and underserved communities

Park DuValle Community Health Center is an Equal Opportunity Employer and welcomes applications from all qualified individuals.

Minimum Qualifications

• Associate's degree in healthcare administration, Business Administration, or a related field.
• 2 years of experience in healthcare administration, provider enrollment, credentialing support and billing in a healthcare setting; or an equivalent combination of education and experience.
• Experience working with healthcare providers, credentialing vendors, or payer organizations.

Required Skills

• Familiarity with provider credentialing and/or enrollment processes.
• Exposure to CAQH and healthcare payer systems.
• Strong organizational skills with the ability to manage multiple priorities and deadlines.
• Excellent written and verbal communication skills.
• High attention to detail and accuracy in documentation and data entry.
• Proficiency with Microsoft Office Suite (Excel, Word, Outlook).
• Ability to quickly learn credentialing software, payer portals, and electronic medical record (EMR) systems.
• Strong interpersonal skills and ability to collaborate effectively with providers, vendors, and cross‑functional teams.
• Customer service mindset with strong problem‑solving abilities.