Credentialing Coordinator
About The Position
WellPower envisions a community where every person’s mental health is fostered through strength, resilience and hope. We empower people to overcome barriers and achieve lasting well-being through collaborative behavioral health care and comprehensive support. Our Guiding Principles: Person Centered. We honor people’s identities, lived experience and journeys and treat every person with the dignity we all deserve. Exceptional Care. We offer compassionate, innovative services that meet people where they are, from immediate support to long-term recovery. Integrity. We operate from a deep foundation of ethical, accountable practices in all we do. Organizational Resilience. We meet the moment and adapt to changing contexts with collaborative creativity, agile business processes, and financial stewardship. Position Summary: The Credentialing Coordinator is responsible for managing and maintaining the credentialing and re-credentialing process for healthcare providers, interns/students/residents and volunteers to ensure compliance with regulatory standards, accreditation requirements, and organizational policies. This role ensures that all WellPower Medical Staff meet the qualifications and maintain active status with insurance networks and governing bodies while also developing and maintaining a working knowledge of relevant statues and laws.
Requirements
- High School Diploma or GED.
- 2+ years of medical credentialing and /or provider enrollment experience
- Work Location: This is a hybrid opportunity open to folks residing in the Greater Denver Metro area.
- Shift/Hours: For example: This is a Monday-Friday opportunity observing standard business hours.
- Physical Requirements: Requires sitting, standing, bending and reaching. May require lifting up to 20 pounds. Requires manual dexterity sufficient to operate standard office machines such as computers, fax machines, the telephone and other office and/or clinical equipment.
- Working Conditions: This is a full-time, hybrid position with a standard schedule of Monday through Friday during regular business hours. The role includes a combination of remote work and on-site presence at the organization’s main office, as needed to support credentialing activities, meetings, and events.
Nice To Haves
- Associate's degree in healthcare administration, business, or relevant work preferred
Responsibilities
- Collect, verify, and process provider documentation including but not limited to licenses, certifications, education, work history, and malpractice history.
- Submit applications to insurance payers and monitor approval status.
- Maintain accurate and up-to-date credentialing files in compliance with NCQA, HRSA, CMS, and state regulations.
- Ensure adherence to organizational policies, federal and state regulations, and accreditation standards.
- Track expiration dates for licenses, certifications, and other credentials; notify providers of upcoming renewals.
- Verify all renewal information and update the provider credentialing file
- Maintain credentialing database and provider records with high accuracy.
- Generate reports for leadership and assist with audits as needed.
- Maintain CAQH and NPI profiles for providers
- Serve as a liaison between providers, insurance companies, and internal departments.
- Perform other duties as assigned
- Maintain a trauma informed environment of wellbeing.
- Other duties as assigned
Benefits
- For complete overview of our robust Benefits: https://wellpower.org/workplace-of-choice/
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
501-1,000 employees
