Credentialing Coordinator

Confluent Health • UNAVAILABLE, UNAVAILABLE

8d

About The Position

The Credentialing Coordinator is an entry-level position responsible for maintaining accurate, complete, and current credentialing information for new and existing healthcare providers. The primary focus of this role is managing provider profiles within the Council for Affordable Quality Healthcare (CAQH) system, including initial profile setup, ongoing updates, reattestations, and document maintenance. This position works closely with providers, internal credentialing teams, and other departments to obtain required information, resolve outstanding items, and ensure provider records remain compliant and up to date. The Credentialing Coordinator may also assist with additional credentialing, enrollment, and operational projects as assigned.

Requirements

• High school diploma or equivalent required.
• Strong attention to detail and commitment to data accuracy.
• Ability to organize and prioritize multiple providers, documents, and deadlines.
• Strong written and verbal communication skills.
• Ability to follow established procedures while recognizing and escalating discrepancies.
• Comfortable communicating with healthcare providers and internal business partners.
• Proficiency with Microsoft Office, including Outlook, Excel, and Word.
• Ability to learn new systems and navigate web-based applications.
• Ability to handle confidential and sensitive information appropriately.
• Dependable, responsive, and able to work both independently and collaboratively.

Nice To Haves

• Previous experience in healthcare administration, medical offices, credentialing, data entry, or a similar administrative role is helpful but not required.
• Familiarity with CAQH ProView.
• Experience with provider credentialing, payer enrollment, medical staff services, or healthcare operations.
• Familiarity with healthcare provider documentation, including professional licenses, malpractice insurance, DEA registrations, board certifications, and work-history requirements.
• Experience using credentialing platforms, workflow systems, or shared tracking tools.

Responsibilities

• Create and maintain CAQH profiles for newly hired providers.
• Review and update CAQH profiles for existing providers.
• Complete CAQH reattestations within required timeframes.
• Ensure provider demographic, education, training, employment, licensure, malpractice, disclosure, and practice-location information is accurate and current.
• Upload and maintain required supporting documentation, including licenses, certifications, professional liability insurance, continuing education records, and other credentialing documents.
• Monitor expiring credentials and proactively request updated documentation from providers or internal teams.
• Review CAQH profiles for missing, incomplete, or inconsistent information and resolve identified discrepancies.
• Communicate professionally with providers regarding outstanding information, required documentation, and upcoming deadlines.
• Track provider outreach and follow up regularly until all required information has been received.
• Maintain accurate records within internal credentialing systems, spreadsheets, and tracking tools.
• Protect confidential provider information and follow applicable privacy, security, and organizational requirements.
• Meet established productivity, quality, and turnaround-time expectations.
• Assist with credentialing audits, reporting, data cleanup, special projects, and other departmental initiatives as assigned.
• Provide general administrative support to the Credentialing and Provider Operations teams as needed.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED