Credentialing Coordinator

Select Physical Therapy•Plano, TX

1d•Hybrid

About The Position

Select Medical is seeking a detail-oriented Credentialing Coordinator to support their Credentialing Manager with the full credentialing and re-credentialing process for providers across their outpatient facilities. This role plays a key part in ensuring compliance, accuracy, and smooth onboarding of practitioners. The ideal candidate enjoys working behind the scenes in healthcare administration, wants to continue their career in provider credentialing or a related healthcare role, thrives in collaborative, innovative team environments, and wants to work for an organization devoted to helping others.

Requirements

At least 2 years of experience in provider credentialing or other related healthcare field
Proficient in Windows (Word, Excel, and Access).
Ability to be professionally assertive with internal and external partners to be influential in finding resolutions.
Strong oral and written communication skills with the ability to interact professionally and positively within all levels of the organization.
Detail-oriented with good organizational skills and the ability to maintain accuracy while meeting deadlines and production requirements.
Excellent interpersonal skills and commitment to quality improvement.
Professional with the ability to work well independently as well as collaboratively with a team.

Nice To Haves

Prior credentialing experience.
Knowledge of credentialing processes, terminology, and NCQA standards.
Strong analytical skills, including process improvement and problem resolution.

Responsibilities

Conducts credentialing and re-credentialing in compliance with NCQA and HIPAA standards for internal and external clinicians.
Research and obtain verifications of practitioners’ credentials to complete internal and external credentialing requirements.
Manage state-specific credentialing activities for providers in our outpatient facilities.
Prepare and process all credentialing documentation.
Update and maintain current and accurate practitioner files and database.
Track and report practitioner changes to appropriate parties.
Communicate with practitioners, data banks, state licensing and regulatory bodies, educational programs, health plans, and other company divisions.
Coordinate with health plans to provide practitioner credentialing documentation as required.
Participate in activities associated with health plan site audits and Credentialing Committee meetings.
Coordinate training and educational requirements for credentialing staff.
Provide routine updates and status reports for health plans and other divisions within the company.
Maintain confidentiality of practitioner information.
Collaborate with team members to support process improvement and the development of policies and procedures.
Coordinated efforts with other credentialing and Managed Care personnel.
Troubleshoot with internal business operations and Managed Care contracting to resolve accounts receivable delays due to credentialing issues.
Participate in the development and coordination of departmental CQI initiatives.
Perform other duties as assigned.