Provider Credentialing Onboarding Coordinator

SMG System Medical Group; United States; On-site; USD 40,000 - 60,000; Full time

Job summary

WVU Medicine Morgantown, WV seeks a Credentialing Coordinator to manage the transition of provider credentials, licenses, and certifications. You will serve as liaison among onboarding, Medical Staff Affairs, Recruitment, and state boards to ensure timely credentialing and licensure for physicians and APPs.

Responsibilities include preparing documents, coordinating with CVO, maintaining records, monitoring licenses, and generating credentialing reports.

Qualifications

• Associates Degree or higher with 2 years of healthcare or administrative experience
• Experience with privileging/credentialing preferred
• Ability to interact with department leadership and governance bodies

Responsibilities

• Facilitates the credentialing process for incoming doctors and APPs: licensure, agreements, permissions, and privilege documentation across multiple organizations.
• APP-specific support: payroll liaison, scheduling support, and onboarding logistics including EPIC setup and distribution lists.
• Coordinates reappointment packets and builds reports from multiple data sources to validate volume requirements.
• Tracks state licenses, board certifications, and required training to ensure compliance and up-to-date records for each provider.
• Manages provider evaluations (FPPE and OPPE), logs volumes, and coordinates signatures and approvals.
• Coordinates with Health Partners Network for payor enrollment to ensure provider enrollment with necessary payors.
• Monitors state board websites for changes and communicates updates to leadership.
• Maintains CME records and transcripts; understands JCAHO, NCQA, URAQ, and other regulatory standards.
• Maintains an organized online database recording credentialing statistics and key information for stakeholders.
• Implements data and demographic reporting to generate medical staff profiles and quality indicators; manages credentialing software.
• Processes WVUHS Insurance Provider Enrollment requests and updates provider profiles accordingly.
• Prepares and presents credentialing status reports in departmental meetings; flags potential delays to leadership.
• Supports project work as needed; coordinates with multiple sites across state lines for credentialing at each privilege site.
• Establishes engagement with new faculty from offer to hire and recredentialing cycles every two years at each site.

Skills

Basic computer skills

Communication skills

Confidentiality

Organizational skills

Typing 35 wpm

Education

Associates Degree or High School Diploma

Tools

EPIC

NetLearning

Job description

Welcome! We’re excited you’re considering an opportunity with us! Below, you’ll find other important information about this position.

Coordinates the transition of all relevant provider credentials, licenses, degrees, privileges, and certifications upon signing of a new provider. Operational ownership of the centralized credentialing process includes interfacing with new provider (Physicians & APPs), gathering paperwork from CVO or other institutional governance body, coordinating all relevant documents, authorizations, and credentials for submission processes. This role partners and work closely with department leadership, leaders throughout the system and other facilities including Departmental Leaders, Recruitment, Onboarding, Medical Staff Affairs, Hospital Medical Directors, Community Office Managers, HPN, and various State Board entities.

MINIMUM QUALIFICATIONS

• Associates Degree OR High School Diploma or Equivalent AND 2 years of healthcare or administrative experience

PREFERRED QUALIFICATIONS: EXPERIENCE

• One year of Experience with privileging/credentialing.
• One year of Experience in a healthcare setting.

CORE DUTIES AND RESPONSIBILITIES

1. Facilitates the credentialing process for all incoming doctors and APPs: Applies for state licensure, creates needed agreements, applies for drug dispensing licenses, completes multiple forms and packets, coordinates with outside facilities, training institutions and device companies for privilege specific documentation including international institutions, interacts with references, facilitates interactions between the physician and onboarding team, and acts as the liaison between medical staff affairs/provider enrollment and incoming providers.
2. APP Specific Support: Sets up and coordinates practice and collaborative agreements, monthly meeting minutes for weekly calls, and scheduling. Functions as the APP payroll representative and assists the Manager/Director with APP time off requests, meetings, other clerical functions as needed, including but not limited to obtaining parking passes, ordering scrubs, EPIC set-up, CLB and NetLearning assistance, adding APPs to distribution lists, and email account set up.
3. Coordinates the completion of reappointment packets with providers, including building complex reports from multiple data sources to validate volume requirements.
4. Tracks state licenses, board certifications, and needed training/educational certifications- collaborating with the physician for all initial and renewal requirements to ensure compliance and maintains up to date records for each provider.
5. Manages all provider evaluations- FPPE and OPPE (Quarterly and Yearly)- runs volume logs, coordinates multi-department signatures, obtains med staff approval, and maintains complete records while also distributing to needed partners.
6. Coordinates with Health Partners Network (HPN) for payor enrollment to make sure all providers are enrolled with necessary payors.
7. Monitors the state boards websites for changes and upcoming events and corresponds with leadership about provider matters.
8. Ensure maintenance of CME records and update of transcripts regularly.
9. Maintains working knowledge of JCAHO standards, NCQA standards, URAQ standards, the State Medical Board, and other regulatory agencies particularly with reference to accreditation and quality improvement. Implements the appointment and reappointment process for all of the department faculty and APPS.
10. Manages and maintains an organized, systematic online data base, to record credentialing statistics, and key information that is utilized in multipurpose functions across department and our key stakeholders.
11. Implement and maintain data, statistical and demographic, used to generate accurate medical staff profiles, quality improvement indicators, hospital-specific delineated privilege forms, etc. on an on-going basis. Implement and maintain credentialing software.
12. Processes day-to-day WVUHS Insurance Provider Enrollment requests within the scope of contractual agreements.
13. Maintains updated individual staff profiles, reporting all changes to WVUHS Insurance Provider Enrollment as contracted.
14. Present provider credentialing and onboarding status report in designated departmental meetings. Immediately alerts department leadership of potential delays or barriers to providers’ onboarding date. Ensures required documentation is received and saved to provider personnel files. Completes and submits new hire documents based on individual department’s procedures.
15. Assists in project work as identified by departmental needs.
16. The department maintains clinic schedules and facility affiliations with multiple locations and across multiple state lines- this position requires the candidate to Establish and maintain engagement with new faculty members from date of signed offer letter through hire date and every two years for recredentialing at each site the provider has privileges.

PHYSICAL REQUIREMENTS

• 1. Prolonged periods of sitting.
• 2. Ability to lift 15-20 lbs.
• 3. Extended periods of computer and telephone usage.

WORKING ENVIRONMENT

• 1. Normal office environment.
• 2. May require Travel.

SKILLS AND ABILITIES

• 1. Must possess basic computer knowledge and ability to operate standard office software.
• 2. Must possess strong oral and written communication skills.
• 3. Must have the ability to maintain high standards of confidentiality.
• 4. Must have strong organizational skills.
• 5. Ability to type at least 35 wpm preferred.

Additional Job Description

In office Morgantown, WV Day shift, M-F Scheduled Weekly Hours: 40 Shift: Exempt/Non-Exempt: United States of America (Non-Exempt) Company: SMG System Medical Group Cost Center: 671 SMG Corporate Admin Address: 3040 University Ave Morgantown West Virginia

Equal Opportunity Employer West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.

The West Virginia University Health System is a West Virginia-based academic health system that provides the full continuum of healthcare services at 30 hospitals in West Virginia, Pennsylvania, Ohio, and Maryland. With more than 47,000 employees, of which 7,200 are providers, and $10 billion in total operating revenues, the WVU Health System is anchored by an 890-bed academic medical center and the 150-bed WVU Medicine Golisano Children’s Hospital in Morgantown, West Virginia. Together, the Health System’s hospitals, clinics, and specialty programs provide a comprehensive continuum of care, ranging from community-based primary and specialty services to highly complex, quaternary care and post-acute care.