Credentialing Support Specialist

Jobtailor; Enola (PA); On-site; USD 42,000 - 64,000; Full time

Job summary

Jobtailor is seeking an Credentialing Coordinator in Pennsylvania to manage credentialing and re-credentialing applications, track renewals, and coordinate with payors and facilities. You will maintain records, verify provider information, and ensure timely participation in credentialing cycles.

The role requires 2+ years in healthcare enrollment or credentialing, strong MS 365 skills, and excellent communication.

Qualifications

• 2+ years of experience in healthcare enrollment, credentialing, or medical practice operations.
• Experience with high-volume data collection and stakeholder communication.
• Proficiency with MS 365 applications and PDF editing.
• Ability to multitask across multiple markets and facilities.
• Knowledge of credentialing concepts and primary source verifications.
• PESC certificate a plus.

Responsibilities

• Complete credentialing and re-credentialing applications, tracking and initiating renewals at least 60 days before expiration.
• Maintain records of credentialing communications, submissions, and approvals.
• Communicate proactively with payors throughout credentialing cycles.
• Verify and audit provider directory information in payor databases.
• Audit internal credentialing databases.
• Coordinate urgently with facilities to complete overdue re-credentialing requirements.
• Support internal and external communications that accelerate the credentialing process.
• Prepare rosters for submission to payors.
• Collect, verify, and organize documentation for applications with the Administrator Managed Care Credentialing.
• Troubleshoot and resolve issues hindering timely plan participation.
• Anticipate three-year re-credentialing requirements and support timely completion.
• Provide administrative and project support to the Managed Care Department.
• Support the Managed Care Team and PAM Health facilities with credentialing follow-up.
• Promote PAM Health's mission and vision.
• Maintain confidentiality and comply with applicable policies and procedures.

Skills

High-Volume Data Collection

MS 365 Proficiency

Professional Communication

Multitasking

Attention to Detail

Education

Associate's Degree in Health or Business Administration

High School diploma or GED

Tools

MS Excel

MS Word

MS Outlook

MS PowerPoint

PDF Editing Software

Provider Directory Verification

Primary Source Verification

Job description

Complete credentialing and re-credentialing applications, tracking and initiating renewals at least 60 days before expiration
Maintain records of credentialing communications, submissions, and approvals
Communicate proactively with payors throughout credentialing cycles
Verify and audit provider directory information in payor databases
Audit internal credentialing databases
Coordinate urgently with facilities to complete overdue re-credentialing requirements
Support internal and external communications that accelerate the credentialing process
Prepare rosters for submission to payors
Collect, verify, and organize documentation for applications with the Administrator Managed Care Credentialing
Troubleshoot and resolve issues hindering timely plan participation
Anticipate three-year re-credentialing requirements and support timely completion
Provide administrative and project support to the Managed Care Department
Support the Managed Care Team and PAM Health facilities with credentialing follow-up
Promote PAM Health's mission and vision
Maintain confidentiality and comply with applicable policies and procedures
Participate in OSHA-required training and follow applicable safety and employee health requirements
Report unsafe practices and understand one's role in emergencies

Requirements

• Associate's Degree in Health or Business Administration preferred
• High School diploma or GED with two (2) or more years of relevant work history will be considered
• Two (2) or more years of experience in healthcare enrollment, credentialing, or medical practice operations
• Experience in a role requiring high-volume data collection and stakeholder communication
• Strong proficiency with MS 365 applications (Excel, Word, Outlook, PowerPoint) and PDF editing
• Ability to multitask across multiple markets and facilities
• Critical thinking and problem-solving ability
• Time management and prioritization skills
• Professionalism and exceptional interpersonal, written, and verbal communication skills
• Basic familiarity with Insurance Plans and Medical Databases
• Ability to adhere to strict confidentiality guidelines and operate with integrity and discretion
• Knowledge of commonly used credentialing concepts, practices, and procedures, including Primary Source Verifications, Designated Equivalency Sources, and Malpractice History
• Ability to function independently with minimal direct supervision
• PESC certificate through applicable organization is a plus
• Healthcare facility enrollment experience preferred

Core Competencies

Demonstrates expertise in credentialing processes, including application management, provider directory verification, and compliance with confidentiality guidelines. Proficient in stakeholder communication and data management within healthcare enrollment and medical practice operations.

Highest-signal resume keywords

• Credentialing Experience
• High-Volume Data Collection
• MS 365 Proficiency
• Critical Thinking
• Healthcare Enrollment Knowledge

ATS Optimization Keywords

Hard Skills

• Credentialing
• Data Collection
• Provider Directory Verification
• Primary Source Verification
• Malpractice History Knowledge

Soft Skills

• Time Management
• Problem-Solving
• Interpersonal Communication
• Written Communication
• Verbal Communication

Certifications & Qualifications

• PESC Certificate

Industry Keywords

• Healthcare Enrollment
• Credentialing Concepts
• Managed Care
• Insurance Plans
• Medical Databases

Tools & Technologies

• MS Excel
• MS Word
• MS Outlook
• MS PowerPoint
• PDF Editing Software