Credentialing Coordinator

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

📋 Description

• Oversee the processes for provider credentialing and recredentialing in compliance with regulatory standards and organizational guidelines.

• Gather, assess, and confirm provider documentation, including licenses, certifications, educational background, work history, malpractice insurance, and references.

• Monitor expiration dates for licenses, certifications, and credentials, assisting in timely renewals.

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

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

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

• Liaise with state agencies, licensing boards, CMS, and other external organizations to gather 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 swiftly address credentialing issues in a professional manner.

• Prepare and maintain reports on credentialing status, turnaround times, and other essential metrics.

• Uphold the confidentiality of provider information in compliance with HIPAA and organizational policies.

⛳️ Requirements

• High school diploma or equivalent is required; an associate or bachelor’s degree in Healthcare Administration, Business, or a related field is preferred.

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

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

• Preferred experience in completing and maintaining Medicare and Medicaid enrollment applications and collaborating with commercial payers.

• Experience in supporting credentialing or enrollment for healthcare facilities, locations, branches, or organizations, rather than just individual provider credentialing, is preferred.

• Familiarity with healthcare regulatory requirements, HIPAA, accreditation standards, and payer requirements.

• Experience working with CMS, state Medicaid programs, insurance payers, licensing agencies, or other regulatory entities is preferred.

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

• Strong attention to detail, with the capability to identify missing or inconsistent information and follow through to resolution.

• Excellent written and verbal communication skills, able to collaborate effectively with payers, regulatory agencies, internal leaders, and operational teams.

• Strong organizational and time-management skills, capable of independently handling competing priorities in a remote, fast-paced environment.

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

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

• Preferred experience in facility credentialing and payer enrollment.

• Experience in 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 in home healthcare, DME, pediatric healthcare, or another multi-location healthcare organization 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 financial future.

• Tuition Reimbursement to encourage your educational and professional advancement.

• Opportunities for Professional Development & Learning.

• Health and Dental Insurance coverage.

• Short & Long Term Disability and Life Insurance options.