Credentialing Coordinator

Position Summary

We are seeking a Credentialing Coordinator to serve as the primary liaison between our organization and an external credentialing partner. While the majority of the initial credentialing process will be managed by the third-party credentialing company, this role will monitor progress and ensure compliance with requirements, maintain provider records, and coordinate communication among stakeholders.

Position Responsibilities

• Serve as the primary liaison between Park DuValle Community Health Center and an external credentialing vendor regarding credentialing and enrollment activities.
• Cookordinate the collection of required documentation for provider payor enrollment (Medicaid, Medicare, etc.), and revalidation requests.
• Track the status of provider payor enrollment and revalidation applications submitted by the credentialing vendor and maintain accurate records.
• Maintain organized credentialing and payor enrollment files, including application status, supporting documentation, and payer correspondence.
• Communicate provider updates to include practice location changes, reassignment of benefits, and other required information to the credentialing vendor.
• Follow up with the credentialing vendor and payers regarding outstanding documentation, application status, or processing delays.
• Update provider information within the electronic medical record (EMR) and other internal systems as needed.
• Collaborate with Human Resources to ensure collection of onboarding documentation required for provider credentialing and payor enrollment.
• Support resolution of credentialing denials, requests for additional information, and revalidation requirements by coordinating with the credentialing vendor and internal departments.
• Monitor credentialing timelines and help ensure required documentation and renewals are completed on schedule.
• Prepare routine reports and maintain accurate records related to provider credentialing and enrollment activities.
• Perform other related duties as assigned.

Benefits & Perks

• Medical, dental, vision, and life insurance
• Voluntary benefits, including short-term disability
• 403(b) retirement plan with employer match up to 5%
• Paid Time Off (PTO)
• Eleven paid holidays
• Predictable work schedule
• Opportunity to serve diverse and underserved communities

Minimum Qualifications

• Associate's degree in healthcare administration, Business Administration, or a related field.
• 2 years of experience in healthcare administration, provider enrollment, credentialing support and billing in a healthcare setting; or an equivalent combination of education and experience.
• Experience working with healthcare providers, credentialing vendors, or payer organizations.

Required Skills

• Familiarity with provider credentialing and/or enrollment processes.
• Exposure to CAQH and healthcare payer systems.
• Strong organizational skills with the ability to manage multiple priorities and deadlines.
• Excellent written and verbal communication skills.
• High attention to detail and accuracy in documentation and data entry.
• Proficiency with Microsoft Office Suite (Excel, Word, Outlook).
• Ability to quickly learn credentialing software, payer portals, and electronic medical record (EMR) systems.
• Strong interpersonal skills and ability to collaborate effectively with providers, vendors, and cross-functional teams.
• Customer service mindset with strong problem-solving abilities.