Credentialing Coordinator

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

📋 Description

• Oversee the provider credentialing and recredentialing processes, ensuring compliance with regulatory standards and organizational policies.

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

• Monitor expiration dates for licenses, certifications, and credentials to facilitate timely renewals.

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

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

• Ensure the precision of provider information in credentialing software, files, and tracking systems.

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

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

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

• Identify and address credentialing issues promptly and professionally.

• Prepare and maintain reports related to credentialing status, turnaround times, and other critical 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 working with commercial payers.

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

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

• 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 simultaneously.

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

• Excellent written and verbal communication skills, capable of effectively interacting with payers, regulatory agencies, internal leadership, and operational teams.

• Strong organizational and time-management skills, able to independently handle competing priorities in a remote, fast-paced setting.

• Proficient in Microsoft Office and experienced with credentialing, enrollment, or healthcare management systems.

• Demonstrated 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.

• Experience with Medicare, Medicaid, and commercial payer enrollment.

• Experience assisting with credentialing audits, renewals, and regulatory requests.

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

🏝️ Benefits

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

• 401(k) Matching to help secure your financial future.

• Tuition Reimbursement to foster your educational and professional development.

• Opportunities for Professional Development & Learning.

• Comprehensive Health and Dental Insurance.

• Short & Long Term Disability and Life Insurance.