Provider Credentialing & Compliance Coordinator

Washington Health Medical Group; Fremont (CA); On-site; USD 40,000 - 48,000; Full time

Benefits offered by this job

401(k)

401(k) matching

Dental insurance

Disability insurance

Employee assistance program

Flexible spending account

Health insurance

Life insurance

Paid time off

Parental leave

Vision insurance

Job summary

Washington Township Medical Foundation is seeking a Credentialing Coordinator to support the Credentialing Department under the HR and Administrative Services leadership. You will process credentialing and re-credentialing for physicians, NPs, and PAs, verify licenses, education, and certifications, and maintain CAQH and payer databases.

This is a full-time, on-site role in a professional office environment.

Qualifications

• Must have at least 6 months to a year of related credentialing experience.
• Proficiency in Microsoft Office Suite
• Must have strong organizational skills to effectively prioritize, coordinate, perform and complete multiple duties and assignments concurrently and in a timely manner.
• Must have the ability to communicate effectively and handle sensitive/confidential information.
• Knowledge of and proficiency in English composition, spelling, grammar, punctuation, and basic math principles.

Responsibilities

• Process initial credentialing and re-credentialing applications for physicians, NPs and PAs.
• Verify licenses, certifications, education, work history, and malpractice coverage through Healthguard for primary source verification.
• Maintain credentialing databases (e.g., CAQH, payer portals) and ensure timely updates.
• Track expiration dates for licenses, DEA registrations, and certifications; proactively follow up to prevent lapses.
• Maintain Rosters.
• Administrator for Payors, including, but not limited to: granting/removing employee access, password resets, etc.
• Prepare credentialing files for internal committee review and payer submission.
• Communicate with providers to collect required documentation.
• Ensure compliance with NCQH and state/federal regulations.
• Respond to inquiries from health plans, hospitals, and internal stakeholders regarding provider status.
• Maintain confidentiality of sensitive provider information.
• Back up to the Executive Assistant/Manager of Administration.
• Other duties as assigned.

Skills

Credentialing experience

Organizational skills

Communication skills

English composition

Basic math principles

Tools

Microsoft Office Suite

Job description

Washington Township Medical Foundation is seeking a Credentialing Coordinator to support the Credentialing Department under the HR and Administrative Services leadership. You will process credentialing and re-credentialing for physicians, NPs, and PAs, verify licenses, education, and certifications, and maintain CAQH and payer databases.

This is a full-time, on-site role in a professional office environment.