Credentialing Coordinator [AQ-15462]

About the role

Aquent is proud to partner with a leading organization within the dynamic healthcare sector, dedicated to ensuring the highest standards of patient care. This organization plays a pivotal role in upholding the quality and safety of healthcare services, impacting the lives of countless patients through its rigorous processes and commitment to excellence. Joining this team means contributing directly to the integrity and reliability of healthcare, working within a supportive environment that values precision, compliance, and collaborative success.

Responsibilities

• Review and process initial credentialing and re-credentialing files for clinicians, ensuring thoroughness and accuracy.
• Establish and maintain robust systems for the timely processing of credentialing files, adhering to industry accreditation standards.
• Query relevant organizations and meticulously evaluate responses to ensure provider compliance with established standards.
• Maintain comprehensive copies of current state licenses, DEA certificates, malpractice coverage, and all other necessary credentialing documents for providers.
• Thoroughly review all background checks, drug tests, and TB screenings, accurately recording the results.
• Compile all verified information and prepare detailed files for presentation to the Credentialing Committee.
• Verify providers’ specific requirements for approval to practice in various states and health plans.
• Provide essential support for the ongoing monitoring of contracted clinicians.
• Utilize credentialing database systems to perform queries, generate reports, and enhance operational efficiency.
• Offer administrative support to department leadership and both internal and external stakeholders, fostering collaborative relationships.
• Uphold the highest level of professionalism at all times, ensuring timely and professional communication.
• Actively contribute to a team-oriented environment and assist with special projects as needed.
• Maintain strict security and privacy of all protected health information (PHI) accessed during work activities.

Must-Have Qualifications

• 1–3+ years of successful work experience in a credentialing role or department, with a strong preference for medical staff (hospital-based) credentialing experience.
• Intermediate proficiency with Google Suite, including Google Sheets, Docs, and Gmail.
• Demonstrated working knowledge of NCQA accreditation standards.
• Hands-on experience completing Primary Source Verification (PSV) for state licenses, DEA, malpractice coverage, background checks, and screenings.
• Experience working within credentialing database systems.
• Active listening skills and the ability to provide and receive constructive feedback.
• Strong interpersonal skills, with the ability to build rapport and productive relationships with internal and external stakeholders.
• High school diploma or up to 1 year of equivalent experience.

Nice-to-Have Qualifications

• 2–5 years of total credentialing experience.
• Experience in hospital or health system environments.
• Experience preparing files for credentialing committee review.
• Working knowledge of problem-solving and decision-making skills.
• Ability to effectively organize and prioritize workload and daily tasks.
• Ability to obtain NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility.