Credentialing Coordinator Jobs

About The Position

Requirements

• Associate’s degree with three years of credentialing experience, or a bachelor’s degree with two years of credentialing experience.
• Comprehensive understanding of medical staff bylaws, rules, and regulations, and external agency requirements including The Joint Commission, CMS, and state laws.
• Ability to manage complex credentialing files, verify credentials, and maintain accurate records to ensure compliance and timely processing.
• Ability to identify issues in credentialing processes, analyze information, and recommend solutions to maintain quality and compliance.
• Strong verbal and written communication skills to interact diplomatically with physicians, leadership, and external agencies.
• Ability to prioritize tasks, manage multiple deadlines, and work efficiently in a high-stress environment with frequent interruptions.
• Skill in using credentialing software systems, electronic file management, and standard office applications.

Responsibilities

• Manage initial and reappointment credentialing applications, ensuring completeness and compliance with internal and external standards.
• Verify education, training, licensure, certifications, and work history through primary source verification.
• Maintain accurate and up-to-date electronic and/or hard-copy credentialing files and track expirable items such as licenses and certifications.
• Support privilege-granting evaluation and decision-making by providing accurate documentation and analysis.
• Process credentialing activities promptly to facilitate physician onboarding and reappointments.
• Communicate credentialing requirements and status updates to medical staff, department chiefs, and leadership.
• Monitor compliance with accreditation standards, CMS Conditions of Participation, and state regulations related to credentialing and privileging.
• Identify and escalate potential quality-of-care or behavioral issues found during credentialing reviews.
• Represent administrative issues and foster collaboration between physicians and hospital leadership.
• Participate in continuing education, mandatory training, and professional development to maintain current knowledge of credentialing standards and best practices.