Overview
Position Summary
The Credentialing Coordinator is an entry-level position responsible formaintainingaccurate, complete, and current credentialing information for new and existing healthcare providers. The primary focus of this role is managing provider profiles within the Council for Affordable Quality Healthcare (CAQH) system, including initial profile setup, ongoing updates,reattestations, and document maintenance.
This position works closely with providers, internal credentialing teams, and other departments to obtain required information, resolve outstanding items, and ensure provider recordsremaincompliant and up to date. The Credentialing Coordinator may alsoassistwithadditionalcredentialing, enrollment, and operationalprojects asassigned.
Responsibilities
- Create and maintain CAQH profiles for newly hired providers.
- Review and update CAQH profiles for existing providers.
- Complete CAQH reattestations within required timeframes.
- Ensure provider demographic, education, training, employment, licensure, malpractice, disclosure, and practice-location information isaccurateand current.
- Upload andmaintainrequired supporting documentation, including licenses, certifications, professional liability insurance, continuing education records, and other credentialing documents.
- Monitor expiring credentials and proactively request updated documentation from providers or internal teams.
- Review CAQH profiles for missing, incomplete, or inconsistent information and resolveidentifieddiscrepancies.
- Communicate professionally with providersregardingoutstanding information,requireddocumentation, and upcoming deadlines.
- Track provider outreach and follow up regularly until all required information has been received.
- Maintainaccuraterecords within internal credentialing systems, spreadsheets, and tracking tools.
- Protect confidential provider information and follow applicable privacy, security, and organizational requirements.
- Meet established productivity, quality, and turnaround-time expectations.
- Assistwith credentialing audits, reporting, data cleanup, special projects, and other departmentalinitiatives asassigned.
- Provide general administrative support to the Credentialing and Provider Operations teams as needed.
Qualifications
- High school diploma or equivalent required.
- Previousexperience in healthcare administration, medical offices, credentialing, data entry, or a similar administrative role is helpful but notrequired.
- Strong attention to detail and commitment to data accuracy.
- Ability to organize and prioritize multiple providers, documents, and deadlines.
- Strong written and verbal communication skills.
- Ability to follow established procedures while recognizing and escalating discrepancies.
- Comfortable communicating with healthcare providers and internal business partners.
- Proficiencywith Microsoft Office, including Outlook, Excel, and Word.
- Ability to learn new systems and navigate web-based applications.
- Ability to handle confidential and sensitive information appropriately.
- Dependable, responsive, and able to work both independently and collaboratively.
Preferred Qualifications
- Familiarity with CAQH ProView.
- Experience with provider credentialing, payer enrollment, medical staff services, or healthcare operations.
- Familiarity with healthcare provider documentation, including professional licenses, malpractice insurance, DEA registrations, board certifications, and work-history requirements.
- Experience using credentialing platforms, workflow systems, or shared tracking tools.
About
Confluent Health, LLC and its affiliates areequal opportunity employers committed to building a diverse and inclusive workforce. We do not discriminate based on race, color, religion, sex, sexual orientation, gender (including pregnancy, childbirth, or related medical conditions), gender identity or expression, national origin,marital status,age, disability, veteran status, or other applicable legally protected characteristics.If you need assistance or would like to request an accommodation due to a disability, please contact us at careers@goconfluent.com.