Credentialing Coordinator

This is a fully remote position, open to applicants in Kansas, +1 more state.

📋 Description

• Oversee the processes of provider credentialing and recredentialing in alignment with regulatory standards and organizational policies.

• Gather, assess, and validate provider documentation, which includes licenses, certifications, education, work history, malpractice insurance, and references.

• Monitor the expiration dates of licenses, certifications, and credentials to assist with timely renewals.

• Accurately complete and submit enrollment applications for Medicare and Medicaid within specified timelines.

• Act as the main point of contact for providers concerning their credentialing status, necessary documentation, and any outstanding items.

• Ensure that provider information is accurately maintained in credentialing software, files, and tracking systems.

• Liaise with state agencies, licensing boards, CMS, and other external organizations to obtain or verify provider information.

• Assist with credentialing-related audits, inquiries, and requests for information.

• Collaborate with Human Resources, Compliance, and Clinical Operations to facilitate a seamless provider onboarding and credentialing process.

• Identify and promptly address credentialing issues in a professional manner.

• Prepare and keep reports related to credentialing status, turnaround times, and other significant metrics.

• Uphold the confidentiality of provider information in accordance with HIPAA and organizational regulations.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• An associate or bachelor’s degree in Healthcare Administration, Business, or a related field is preferred.

• Preferably 1–3 years of experience in healthcare credentialing, facility credentialing, payer enrollment, compliance, or healthcare administration.

• Strong preference for experience with facility-level credentialing and enrollment.

• Familiarity with completing and maintaining Medicare and Medicaid enrollment applications, as well as working with commercial payers, is preferred.

• Experience supporting credentialing or enrollment processes for healthcare facilities, locations, branches, or organizations is preferred, rather than focusing solely on individual provider credentialing.

• Knowledge of healthcare regulatory requirements, HIPAA, accreditation standards, and payer requirements is essential.

• Preferred experience working with CMS, state Medicaid programs, insurance payers, licensing agencies, or other regulatory bodies.

• Ability to manage multiple applications, renewals, licenses, certifications, deadlines, and outstanding documentation concurrently.

• Strong attention to detail with a knack for identifying missing or inconsistent information and ensuring resolution.

• Excellent written and verbal communication skills with the capability to interact effectively with payers, regulatory agencies, internal leaders, and operational teams.

• Strong organizational and time-management skills, with the ability to independently handle competing priorities in a remote, fast-paced environment.

• Proficiency in Microsoft Office and experience with credentialing, enrollment, or healthcare management systems.

• Proven accountability, responsiveness, and consistent follow-through.

• Preferred experience in facility credentialing and payer enrollment.

• Experience credentialing or enrolling multiple healthcare locations, facilities, or branches across various states is preferred.

• Preferred experience with Medicare, Medicaid, and commercial payer enrollment.

• Experience in supporting credentialing audits, renewals, and regulatory requests is preferred.

• Experience within home healthcare, DME, pediatric healthcare, or other multi-location healthcare organizations is preferred.

🏝️ Benefits

• Generous Paid Time Off (PTO) for full-time employees to promote a healthy work-life balance.

• 401(k) Matching to assist in securing your future.

• Tuition Reimbursement to foster your educational and professional development.

• Opportunities for Professional Development & Learning.

• Health and Dental Insurance.

• Short & Long Term Disability and Life Insurance.