Credentials Coord-Provider Enrollment-Team Lead
About The Position
Why This Role Matters Behind every provider who delivers exceptional patient care is a credentialing professional making sure everything is accurate, compliant, and on time. As a Credentials Coordinator – Provider Enrollment, you play a critical role in ensuring our providers are properly credentialed and enrolled so they can focus on what matters most—caring for patients. This role is ideal for someone who thrives on details, enjoys working independently, and values collaboration with physicians, managed care organizations, and internal partners across the system. What You’ll Do You’ll manage the full lifecycle of provider credentialing and enrollment, including:
Requirements
- High School Diploma or equivalent
- Certified Professional Credentialing Specialist (CPCS) or equivalent
- At least 3 years of experience in medical staff credentialing, managed care credentialing, or a related area
- Strong computer skills with exceptional attention to detail and accuracy
- Ability to manage multiple priorities and meet deadlines
- Sound independent judgment and the ability to work constructively with physicians and professionals
Nice To Haves
- Experience with medical staff credentialing or delegated credentialing in a medical center setting
Responsibilities
- Coordinate initial credentialing, reappointments, and recredentialing for Medicare, Medicaid, and Managed Care organizations
- Prepare, review, submit, and track credentialing and payer enrollment applications, including CAQH
- Perform all phases of delegated credentialing, including audits, reports, rosters, and database queries
- Maintain accurate and up-to-date provider records within credentialing software and paper files
- Track credentialing activity status and follow up with payers to ensure timely approvals
- Record provider billing numbers and communicate updates to professional billing and revenue integrity teams
- Prepare correspondence, verification requests, reappointment materials, and credentialing packets
- Serve as a professional point of contact for medical staff, department leaders, managed care representatives, and administrative partners
- Support departmental operations through administrative tasks such as scanning, filing, and mass mailings
- Promote quality improvement, patient safety, compliance, and cultural diversity through daily work
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
