Credentialing Coordinator: Audit-Ready Provider Ops

Transcarent; United States; On-site; USD 60,000 - 85,000; Full time

Benefits offered by this job

Medical coverage

401(k) plan

Paid time off

Life Insurance

Wellness benefits

Job summary

Transcarent is seeking a Credentialing Coordinator to manage day-to-day credentialing and re-credentialing, ensuring NCQA-compliant files for our provider network.

You will perform primary source verification, review data, and collaborate with cross-functional teams to resolve issues and support audits. This role emphasizes accuracy, efficiency, and timely turnaround in a fast-paced health care innovator.

Qualifications

• Bachelor's degree in healthcare, business, or a related field, or equivalent experience.
• 3+ years of experience in provider credentialing, medical staff services, healthcare operations, or a related operational role
• Working knowledge of NCQA credentialing standards and primary source verification requirements
• Familiarity with provider licensure requirements across multiple states
• Strong analytical and problem-solving skills, with the ability to review detailed information and make sound decisions
• Highly organized and detail-oriented, with the ability to manage multiple tasks and priorities
• Comfortable working independently and as part of a team, with minimal direct supervision
• Results-oriented, with experience meeting productivity, quality, and turnaround expectations
• Excellent interpersonal and communication skills; willingness to ask questions, speak up, and seek clarity when needed
• Comfortable in a fast-paced and evolving organization with a willingness to be flexible and support urgent operational needs

Responsibilities

• Execute day-to-day credentialing and re-credentialing work in support of our provider network, ensuring timely, accurate, and compliant completion of assigned deliverables
• Process initial credentialing and re-credentialing applications by reviewing provider files against NCQA standards, payer requirements, and internal guidelines
• Perform primary source verification, including licensure, board certification, education, work history, malpractice history, and sanctions checks
• Execute supporting tasks related to delegated credentialing audits and payer credentialing submissions
• Partner closely with the credentialing team members to help manage caseload, meet turnaround times, and maintain file quality
• Collaborate with provider relations, licensing, compliance, and network operations partners to resolve questions, issues, escalations, and delays
• Review provider data, applications, and supporting documentation to identify discrepancies, expirables, or items requiring follow-up
• Document findings clearly in the credentialing database and elevate non-standard situations when appropriate
• Follow established policies, procedures, and workflows while maintaining a high level of detail and accuracy in preparation for internal and external audits

Skills

Analytical mindset

Detail-oriented

Independent worker

Strong communication

Education

Bachelor's degree in healthcare, business, or related field

Tools

Verifiable

Availity

CAQH

Job description

Transcarent is seeking a Credentialing Coordinator to manage day-to-day credentialing and re-credentialing, ensuring NCQA-compliant files for our provider network.

You will perform primary source verification, review data, and collaborate with cross-functional teams to resolve issues and support audits. This role emphasizes accuracy, efficiency, and timely turnaround in a fast-paced health care innovator.