Credentialing Coordinator
Core
Coordinate and process initial and re-credentialing applications for healthcare providers to ensure network participation and compliance with payer and regulatory requirements.
Role type
Operational Credentialing Coordinator
Builds
Provider network participation and compliance status
Domain
Healthcare administration / Credentialing
Deliverable
dashboards & analysis
Required skills
Credentialing processes, Payer enrollment, Regulatory compliance, Data integrity, Stakeholder communication, Report generation
Preferred skills
CAQH portal, Credentialing software, Microsoft Office Suite, Process improvement
Responsibilities
Prepare and submit credentialing applications, Maintain accurate provider records, Monitor licensure and certification expiration dates, Resolve participation and demographic discrepancies, Generate credentialing status and aging reports, Support accreditation surveys and regulatory reviews