Credentialing Coordinator

Aylo Health•Atlanta, GA

About The Position

The Credentialing Coordinator is responsible for verifying, maintaining, and monitoring the credentials of all clinical staff to ensure compliance with state, federal, and organizational requirements. This role plays a critical part in protecting patient safety, maintaining regulatory compliance, and supporting operational excellence by ensuring all credentialing files are accurate, complete, current, and confidential.

Requirements

Exceptional attention to detail and organizational skills
Strong written and verbal communication abilities
Effective problem-solving and follow-up skills
Ability to manage multiple deadlines and priorities
Working knowledge of healthcare credentialing, regulatory compliance, and verification processes
Experience with credentialing databases or credentialing software preferred
High school diploma or equivalent.
2–3 years of experience in provider credentialing, provider enrollment, or healthcare administration.
Strong knowledge of credentialing processes and primary source verification.
Experience working with health plans, hospitals, and provider networks.
Proficiency with credentialing software, databases, and online verification systems.
Excellent attention to detail, organization, and time management skills.
Strong written and verbal communication skills.

Nice To Haves

Associate’s or Bachelor’s degree in healthcare administration, business, or a related field.
Experience with delegated credentialing programs.
Familiarity with NCQA standards and CMS requirements.
Credentialing certification (CPCS, CPMSM, or equivalent).

Responsibilities

Confirm that all required licenses, certifications, and credentials for staff members are current and valid
Gather, review, and verify provider credentials including licenses, certifications, education, training, and work history
Identify discrepancies or gaps in credentialing information and follow up to investigate and resolve issues
Implement and manage the credential renewal process to ensure timely updates and prevent lapses
Maintain complete, accurate, and up-to-date credentialing files for all credentialed providers.
Ensure credentialing documentation is properly stored and data is backed up according to organizational standards
Preserve strict confidentiality of all employee and provider information
Ensure credentialing activities comply with applicable state, federal, payer, and organizational requirements
Prepare credentialing reports for management, committees, and audits as needed
Respond to external credentialing inquiries from payers, regulatory agencies, and other organizations
Serve as a point of contact for internal staff, providers, licensing boards, and insurance networks regarding credentialing matters
Screen credentialing applications and prepare materials for review by credentialing committees