Credentialing Coordinator

TEKsystems

3d•Remote

About The Position

The Provider Credentialing & Enrollment Specialist supports the onboarding of healthcare providers by managing credentialing and enrollment workflows. This role ensures compliance with regulatory and accreditation standards while facilitating timely provider participation and reimbursement.

Requirements

High school diploma or equivalent required; associate or bachelor’s degree preferred.
Minimum of 2 years of experience in healthcare credentialing and/or provider enrollment.
Hands-on experience with credentialing and enrollment systems such as CAQH, PECOS, and Availity.
Strong attention to detail with the ability to accurately review and verify complex provider documentation.
Excellent written and verbal communication skills.
Proven ability to manage multiple priorities, meet deadlines, and work independently.
Working knowledge of HIPAA and healthcare compliance standards.

Nice To Haves

Experience preparing credentialing files for Credentialing Review Board submission.
Familiarity with payer enrollment processes and provider onboarding workflows.

Responsibilities

Verify provider credentials, including licenses, certifications, education, training, work history, board certifications, and malpractice history.
Manage and review credentialing files to confirm completeness and readiness for submission to the Credentialing Review Board.
Support end‑to‑end provider onboarding by maintaining accurate and compliant credentialing and enrollment records.
Ensure adherence to HIPAA, regulatory, and organizational compliance requirements throughout the credentialing process.
Track pending credentialing and enrollment applications, identifying and resolving issues that may delay approval.
Communicate effectively with internal stakeholders and external entities to support timely credentialing decisions.