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Title
Text copied to clipboard!Credentialing Coordinator
Description
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We are looking for a Credentialing Coordinator to join our team and oversee the credentialing and re-credentialing processes for healthcare providers. The Credentialing Coordinator will be responsible for ensuring that all healthcare professionals meet the necessary licensing, certification, and regulatory requirements to provide care within our organization. This role involves collecting, verifying, and maintaining documentation, as well as communicating with providers, regulatory agencies, and insurance companies. The ideal candidate will have strong organizational skills, attention to detail, and the ability to manage multiple tasks simultaneously. The Credentialing Coordinator will play a critical role in maintaining compliance with industry standards and ensuring the highest level of patient safety and care. Key responsibilities include processing credentialing applications, tracking expirations and renewals, conducting background checks, and maintaining accurate records in credentialing databases. The Credentialing Coordinator will also assist with audits, respond to inquiries from internal and external stakeholders, and stay up-to-date with changes in credentialing requirements. This position requires excellent communication skills, discretion with sensitive information, and a commitment to supporting a culture of compliance and excellence in healthcare delivery.
Responsibilities
Text copied to clipboard!- Process initial and re-credentialing applications for healthcare providers
- Verify provider credentials, licenses, and certifications
- Maintain accurate and up-to-date credentialing files and databases
- Track expirations and ensure timely renewals of credentials
- Communicate with providers, regulatory agencies, and insurance companies
- Assist with audits and ensure compliance with accreditation standards
- Conduct background checks and monitor sanctions or disciplinary actions
- Respond to internal and external credentialing inquiries
- Stay informed about changes in credentialing regulations and requirements
- Support continuous improvement of credentialing processes
Requirements
Text copied to clipboard!- High school diploma or equivalent; associate or bachelor’s degree preferred
- Experience in credentialing or healthcare administration is highly desirable
- Strong organizational and time management skills
- Excellent attention to detail and accuracy
- Proficient in Microsoft Office and credentialing software
- Ability to handle sensitive and confidential information
- Strong written and verbal communication skills
- Ability to work independently and as part of a team
- Knowledge of healthcare regulations and accreditation standards
- Problem-solving skills and adaptability
Potential interview questions
Text copied to clipboard!- What experience do you have with provider credentialing?
- How do you ensure accuracy and compliance in your work?
- Describe your experience with credentialing software or databases.
- How do you handle sensitive or confidential information?
- Can you provide an example of managing multiple deadlines?
- What steps do you take to stay updated on credentialing regulations?
- Describe a time you resolved a credentialing issue.
- How do you communicate with providers and regulatory agencies?
- What motivates you to work in healthcare administration?
- Are you familiar with any accreditation standards (e.g., NCQA, JCAHO)?
