Credentialing Coordinator

Grady Health System; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Grady Health System in the Atlanta area seeks a Credentialing Coordinator to manage initial credentialing and recredentialing of physicians and advanced practice providers. You will gather data from primary sources and ensure compliance with TJC, NCQA, and federal requirements.

The role requires independent processing, attention to detail, confidentiality, and collaboration with Medical Staff Services and service chiefs. Experience with managed care contracts and provider files is essential.

Qualifications

• Three years of credentialing/privileging experience in a hospital or managed care setting and/or Medical Staff Services.
• Two years of database experience.
• Three years minimum in progressively responsible positions in a complex business/administrative office setting, which includes working with physicians, advanced practice providers or other professional groups

Responsibilities

• Communicates completion of applications to Medical Staff Services Director and appropriate review by Service Chiefs.
• Assists with FPPE and OPPE collection.
• Coordinates the credentialing/ privileging process for assigned physicians and advanced practice providers
• Acts independently to process credentialing/ privileging applications for physicians and advanced practice providers.
• Maintains thorough understanding of TJC, NCQA and state/federal regulatory credentialing/privileging standards.
• Responsible for the quality and integrity of provider files and meets processing quality and productivity standards.
• Performs routine file audits. Serves as a liaison for physicians and advanced practice providers navigating through the health system.
• Adheres to strict confidentiality requirements
• Analyzes provider applications for completeness, accuracy, consistency, gaps in work history, relevant references, etc.
• Verifies all credentialing/privileging elements, including but not limited to, education, training, board certification, work history, licensure and certifications, case/procedure logs, malpractice coverage, etc through a variety of primary sources as deemed appropriate per TJC standards and other applicable accrediting agencies.
• Identifies/concerns issues and initiates further data collection as needed.
• Initiates appropriate and timely follow-up information from the Medical Staff Services Department or other sources as needed.

Skills

Credentialing experience

Database experience

Education

Diploma

Tools

Database systems

Job description

Remote

Description

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

The Credentialing Coordinator is responsible for all aspects of initial credentialing/privileging and recredentialing/privileging of physicians and advanced practice providers who perform patient care services at Grady Health System. The Credentialing Coordinator independently gathers, conducts and analyzes data/information via the primary source in accordance with the credentialing/privileging standards of all applicable accrediting and regulatory agencies (TJC, NCQA, State, and Federal) as well as the Grady Health System Medical Staff Bylaws and Rules and Regulations and Grady Health System policies and procedures. Performs the initial and re-credentialing of Grady employed providers with all managed care plans and third-party payors through delegated processes in accordance with standards of the Grady Health System policies and procedures, Medical Staff Bylaws, and Grady Managed Care contracts.

RESPONSIBILITIES

• Communicates completion of the applications to the Medical Staff Services Director and appropriate review by the Service Chiefs.
• Assists with FPPE and OPPE collection.
• Coordinates the credentialing/ privileging process for assigned physicians and advanced practice providers
• Acts independently to process credentialing/ privileging applications for physicians and advanced practice providers.
• Maintains thorough understanding of TJC, NCQA and state/federal regulatory credentialing/privileging standards.
• Responsible for the quality and integrity of provider files and meets processing quality and productivity standards.
• Performs routine file audits. Serves as a liaison for physicians and advanced practice providers navigating through the health system.
• Adheres to strict confidentiality requirements
• Analyzes provider applications for completeness, accuracy, consistency, gaps in work history, relevant references, etc.
• Verifies all credentialing/privileging elements, including but not limited to, education, training, board certification, work history, licensure and certifications, case/procedure logs, malpractice coverage, etc through a variety of primary sources as deemed appropriate per TJC standards and other applicable accrediting agencies.
• Identifies/concerns issues and initiates further data collection as needed.
• Initiates appropriate and timely follow-up information from the Medical Staff Services Department or other sources as needed.

QUALIFICATIONS

Must possess and maintain a working knowledge of The Joint Commission, NCQA and state/federal accrediting agencies requirements/standards regarding credentialing/privileging.

Three years of credentialing/privileging experience in a hospital or managed care setting and/or Medical Staff Services, Two years of database experience.

OR

Three years minimum in progressively responsible positions in a complex business/administrative office setting, which includes working with physicians, advanced practice providers or other professional groups

EDUCATION

Diploma

Core Competencies

1. Patient-Centered Care – Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.
2. Integrity & Accountability – Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.
3. Collaboration & Teamwork – Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.
4. Communication – Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.
5. Respect & Inclusion – Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.
6. Quality & Safety – Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.
7. Adaptability & Resilience – Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.
8. Continuous Improvement – Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.
9. Leadership & Professionalism – Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.
10. Employee Experience Focus – Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.