Job Summary We are seeking a highly organized and detail-oriented Credentialing and Accreditation Coordinator to join our healthcare team. This vital role involves managing the credentialing process for healthcare providers, ensuring compliance with accreditation standards, and maintaining accurate records to support regulatory requirements. The coordinator will serve as a key point of contact for provider credentialing, payer enrollment, and accreditation activities, contributing to the overall quality and compliance of our healthcare services. This position offers an exciting opportunity to work within a dynamic healthcare environment dedicated to excellence and continuous improvement. Duties Manage the end-to-end medical credentialing process, including reviewing applications, verifying credentials, and ensuring timely provider enrollment with health insurance payers. Maintain and update provider databases, ensuring accuracy and confidentiality of all credentialing information in healthcare software applications. Coordinate with healthcare providers, payers, and regulatory agencies such as CMS (Centers for Medicare & Medicaid Services) to facilitate smooth credentialing and re-credentialing processes. Monitor compliance with accreditation standards such as NCQA (National Committee for Quality Assurance), JCAHO (Joint Commission), and state healthcare regulations. Prepare and review medical credentialing applications, verifying credentials against licensing boards and other authoritative sources. Support accreditation activities by ensuring adherence to regulatory compliance standards, including CMS regulatory requirements and healthcare accreditation standards. Assist in contract management related to provider agreements and ensure all documentation aligns with healthcare compliance policies. Handle sensitive confidential information with integrity while maintaining meticulous records of all credentialing and accreditation documentation. Skills Strong knowledge of managed care processes, health insurance policies, and payer enrollment procedures. Extensive experience with medical credentialing software applications and database management systems. Proficiency in Microsoft Office Suite (Word, Excel, Outlook) for documentation, reporting, and communication purposes. Familiarity with healthcare software applications used for provider data management and compliance tracking. In-depth understanding of health regulation policies including CMS guidelines, NCQA standards, JCAHO accreditation requirements, and state healthcare regulations. Ability to review medical credentialing applications thoroughly while ensuring accuracy and completeness. Excellent organizational skills with the ability to manage multiple tasks efficiently in a fast-paced environment. Knowledge of medical terminology relevant to credentialing processes and healthcare operations. Experience handling confidential information securely in accordance with healthcare compliance standards. Contract management experience within a healthcare setting is preferred to support provider agreements and regulatory documentation. This role is ideal for motivated professionals eager to contribute to high-quality healthcare delivery through meticulous credentialing practices and rigorous accreditation standards. Join us in fostering excellence in healthcare services by ensuring our providers meet the highest regulatory requirements!

Pay:

$22.00 - $27.00 per hour Expected hours: 40.0 per week

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Work Location:

In person