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Credentialing Coordinator - Clerical
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All's Well Health Care Services
Roseville, CA (In Person)
$73,174 Salary, Full-Time
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Job Description
Job Summary We are seeking a Credentialing Coordinator - Clerical to join our healthcare administration team. This vital role involves managing the credentialing process for healthcare providers, ensuring compliance with industry standards, and maintaining accurate documentation. The ideal candidate will possess strong organizational skills, a thorough understanding of managed care processes, and familiarity with medical terminology and NCQA (National Committee for Quality Assurance) standards. This position offers an opportunity to contribute to the efficiency and integrity of provider credentialing, supporting high-quality patient care and regulatory compliance. Duties Collect, review, and verify provider credentials, licenses, certifications, and other required documentation in accordance with organizational policies and industry standards. Maintain detailed records of credentialing activities using designated databases or tracking systems. Coordinate with healthcare providers, insurance companies, and regulatory agencies to facilitate credentialing and re-credentialing processes. Ensure compliance with managed care requirements and NCQA standards by regularly updating credentialing files. Assist in preparing credentialing applications and renewal packets accurately and timely. Support audit readiness by maintaining organized documentation aligned with accreditation standards. Communicate effectively with internal teams to resolve credentialing discrepancies or issues promptly. Monitor expiration dates of licenses and certifications to ensure continuous provider eligibility. Contribute to process improvements aimed at streamlining credentialing workflows and enhancing accuracy. Stay informed about changes in healthcare regulations that impact provider credentialing requirements. Experience Prior experience working in a medical office or healthcare setting is highly preferred. Knowledge of managed care processes and credentialing procedures is essential. Familiarity with medical terminology enhances accuracy in documentation review. Understanding of NCQA standards supports compliance efforts within healthcare organizations. Strong organizational skills with meticulous attention to detail are required. Excellent communication skills for liaising with providers, insurers, and regulatory bodies. Previous experience with credentialing software or databases is advantageous but not mandatory. This role is an excellent opportunity for detail-oriented professionals passionate about healthcare administration. We welcome candidates eager to support provider credentialing processes that uphold industry standards and contribute to quality patient care.