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Credentialing and Ops Coordinator Position Summary The Credentialing and Ops Coordinator is responsible for supporting provider credentialing, payer enrollment, and operational workflows across the organization. This role works closely with internal teams and external payers to ensure providers are credentialed, enrolled, and maintained in accordance with payer requirements and organizational standards. The coordinator manages credentialing documentation, CAQH profiles, payer portals, and application tracking while identifying opportunities to improve processes, strengthen communication, and support organizational growth. Key ResponsibilitiesProvider Credentialing & Enrollment Coordinate with internal teams to facilitate timely credentialing and enrollment approvals for newly hired providers with Medicare and other applicable payers. Maintain accurate credentialing, licensing, and compliance documentation for clinical staff. Manage CAQH profiles, including updating provider information, completing attestations, and ensuring profiles remain accurate and current. Develop and maintain a working knowledge of in-network (INN) and out-of-network (OON) credentialing requirements and processes. Maintain payer portals and ensure provider information is updated accurately and promptly. Track credentialing and enrollment applications, monitor progress, and follow up with payers regarding outstanding requirements, approvals, and participation in new contracts. Support initial provider enrollment, ongoing maintenance, recredentialing, and revalidation processes. Monitor credentialing timelines and communicate potential delays or outstanding items to the appropriate internal teams. Workflow & Operational Support Maintain and improve internal tracking systems to support credentialing workflows, visibility, accountability, and timely follow-up. Assist with documentation management, record organization, and standardization of credentialing and operational processes. Facilitate communication between departments regarding credentialing status, outstanding requirements, and anticipated timelines. Identify opportunities to improve administrative efficiency, streamline workflows, and strengthen credentialing processes. Support operational special projects, process improvements, and administrative initiatives as assigned. Maintain organized records and follow established procedures to support operational consistency and compliance. Collaborate with cross-functional teams to address workflow challenges and support the organization's continued growth. Qualifications & Experience Minimum of 2 years of relevant experience in provider credentialing, payer enrollment, healthcare administration, or a related field. Experience with in-network (INN) and out-of-network (OON) credentialing preferred. Familiarity with CAQH, Medicare enrollment, payer portals, and provider credentialing processes preferred. Strong organizational skills with the ability to manage multiple applications, deadlines, and priorities. Excellent written and verbal communication skills, with the ability to collaborate effectively across departments. Strong attention to detail and commitment to maintaining accurate documentation. Ability to identify process improvement opportunities and contribute to operational efficiency. A proactive, adaptable mindset and a desire to contribute to organizational growth.

Pay:

$45,000.00 - $50,000.00 per year

Benefits:

401(k) 401(k) matching AD&D insurance Dental insurance Disability insurance Health insurance Life insurance Paid time off Parental leave Retirement plan Vision insurance

Work Location:

Hybrid remote in Massapequa, NY 11758