Credentialing Coordinator

St. Joseph Hospital & Medical Center•Phoenix, AZ

4d•$24 - $36•Onsite

About The Position

St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital located in Phoenix, Arizona. Founded in 1895, it is dedicated to caring for the poor and underserved and is a nationally recognized center for quality quaternary care, medical education, and research. The hospital houses several renowned institutes, including the Barrow Neurological Institute and the Norton Thoracic Institute, and is a Level I Trauma Center. It is also recognized for its high-risk obstetrics, neuro-rehabilitation, and orthopedics services, attracting complex cases from around the world. St. Joseph's is consistently ranked among the top hospitals in the U.S. for neurology and neurosurgery and is an outstanding place to work.

Requirements

High School Diploma / GED
Three (3) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment

Nice To Haves

Bachelors degree
Certified Provider Credentialing Specialist (CPCS)
Five (5) years of experience

Responsibilities

Coordinate and process initial credentialing, recredentialing.
Maintains up-to-date physician database of all applications, demographics, medical licenses, drug enforcement, professional liability insurance, training, board certification etc.
Review credentialing applications for completeness, accuracy, and compliance with regulatory and accreditation standards.
Perform primary source verification of provider licenses, certifications, education, training, work history, malpractice coverage, and sanctions.
Maintain and update provider credentialing files, databases, and tracking systems.
Monitor expiration dates for licenses, certifications, malpractice insurance, and other required credentials; initiate timely follow-up for renewals.
Communicate with providers, medical staff offices, and internal departments to obtain required documentation and resolve discrepancies.
Ensure compliance with NCQA, CMS, state, federal, and organizational credentialing requirements.
Track credentialing timelines and ensure all applications are completed within established turnaround standards.
Support internal and external audits, accreditation reviews, and regulatory reporting activities.
Research and resolve credentialing issues, discrepancies, or incomplete information in a timely manner.
Generate reports and provide status updates related to credentialing activities and provider file compliance.
Maintain confidentiality of provider and organizational information in accordance with HIPAA and company policies.
Assist with process improvement initiatives to enhance credentialing workflow efficiency and accuracy.