Medical Staff Credentialing Coordinator

Sheppard Pratt • Towson, MD

4d • $24 - $37 • Onsite

About The Position

Provides administrative and operational support for credentialing, recredentialing, and privileging behavioral health practitioners and clinical staff. Ensures timely and accurate processing of credentialing applications; maintains practitioner records and credentialing databases; and monitors licensure, certification, and other credential expirations.

The coordinator supports customer service for clinicians and clinical and administrative leadership; initial and reappointment credentialing; primary-source credential verification; electronic file maintenance in accordance with The Joint Commission and State of Maryland requirements; Credentialing Committee review; and tracking expiring licenses, certifications, and insurance. The role also supports temporary privileges, expedited privileging, state updates regarding physician privileges, accreditation surveys, and audits.

The position works with Managed Care Credentialing Coordinators to prepare clinician files for payer audits, maintains an ECHO tracking mechanism, and provides documentation and responses to credentialing inquiries during delegated payer audits. The schedule is Monday through Friday during day-shift hours, and the work is in person.

Requirements

• One of the following education and experience combinations: a bachelor's degree and 3 years of administrative, clerical, or office experience in a healthcare environment; an associate degree and 5 years of experience; or high school education and 7 years of experience.
• Ability to maintain confidential and sensitive information.
• Proficiency in Microsoft Office applications, including Excel, Outlook, Teams, and Word.
• Strong attention to detail and accuracy in data entry and document management.
• Excellent verbal and written communication skills.
• Ability to interpret licenses, certifications, credentialing documents, and regulatory requirements.
• Strong organizational and time-management skills.
• Ability to work independently with minimal supervision.
• Experience maintaining databases and electronic records.
• Ability to maintain a professional demeanor and actively engage in virtual meetings conducted through video-conferencing platforms.
• Ability to prioritize workload, plan for cyclical and daily tasks, and meet deadlines.

Nice To Haves

• Experience or familiarity with behavioral health services.
• Working knowledge of TJC, NCQA, CARF, COMAR, and CMS credentialing, privileging, and regulatory requirements.

Responsibilities

• Provide quality services to clinicians and clinical and administrative leadership.
• Coordinate initial and reappointment credentialing applications.
• Review credentialing and recredentialing applications for completeness and accuracy.
• Obtain and verify required credentials through primary-source verification.
• Maintain electronic credentialing files in accordance with The Joint Commission and State of Maryland requirements.
• Prepare files for Credentialing Committee review.
• Maintain the ECHO database for clinicians and generate reports, queries, letters, and lists as needed.
• Track expiring licenses, certifications, and insurance and provide timely notices to clinicians and supervisors.
• Request temporary privileges and expedited privileging in accordance with policy.
• Compile State of Maryland updates every six months regarding physician privileges.
• Participate in accreditation surveys and audits.
• Update the Director on the status of appointment and reappointment credentialing files.
• Work with Managed Care Credentialing Coordinators to ensure clinician files are complete for pre-delegation and annual delegated payer audits.
• Create and maintain an ECHO tracking mechanism for Managed Care Credentialing Coordinators.
• Provide documentation and respond to credentialing inquiries during managed care delegated payer audits.

Benefits

• Professional development, including a comprehensive tuition reimbursement program to support ongoing education and licensure and/or certification preparation.
• Medical, dental, and vision benefits for benefit-eligible positions.
• 403b retirement match.
• Paid time off for benefit-eligible positions.
• Complimentary Employee Assistance Program (EAP).
• Mileage reimbursement program.

What This Job Offers

• Job Type: Full-time