Credentialing Coordinator

Job Description:


The Credentialing Coordinator is responsible for managing all aspects of provider credentialing, privileging, and payer enrollment for the organization’s multiple business units. This role ensures timely onboarding, accurate payer setup, and regulatory compliance while supporting uninterrupted clinical and revenue cycle operations. The Credentialing Coordinator reports directly to the Revenue Cycle Manager.

Salary : $21/hr-$23/hr

Location : Hybrid position. One day required in person, office located in Bingham Farms, 48025

Responsibilities & Duties:

• Manages the full payer credentialing process, including obtaining applications, completing them accurately, submitting within required timeframes, conducting ongoing follow-up, and securing contracts once approved.
• Maintains organized, accurate provider files, including CAQH, CVs, licenses, certifications, malpractice documentation, and hospital/ASC privileges.
• Maintains a strong working knowledge of payer credentialing rules, enrollment requirements, and internal credentialing policies.
• Maintains a centralized database of all providers, tracking expirations and maintains ongoing communication with medical staff offices to ensure continuous provider privileges. and maintains all licensure, certification, DEA/controlled substance registrations, malpractice insurance, and other professional documents.
• Creates urgency with providers, facilities, and outside contacts by establishing target dates and monitoring document submission timelines.
• Demonstrates exceptional customer service to internal and external stakeholders.
• Coordinates initial and renewal privileging for three internal ASCs and affiliated outpatient ASCs and hospitals.
• Ensures all documentation required for facility privileges is accurate, complete, and submitted timely.
• Maintains confidentiality of patient, physician, and organizational information.
• Serves as a role model in service excellence, customer service and public relations.
• Fulfills responsibilities to the organization by adhering to its goals, objectives, policies and procedures.
• Maintains the confidentiality of patients, physicians and staff.
• Accepts additional responsibilities as assigned by the Revenue Cycle Manager.

Qualifications:

• Must possess a comprehensive knowledge of payer credentialing, as normally obtained through a Bachelor’s degree (or sufficient work experience to waive) in Business or Healthcare Administration or a related field and 3+ years' experience in payer enrollment.
• Superior customer service skills. Strong technological skills with the ability to make recommendations and implement new technical solutions.
• Strong interpersonal skills – team player who is able to prioritize multiple responsibilities, manage a large workload within tight deadlines – works well under pressure and consistently meets deadlines, readily adapts to change and excels in a productivity-based environment.
• High level of professionalism and communication skills to interact with physicians, ACPs, employees at all levels, and vendors.

Minimum Competencies:

• Ability to organize and prioritize work and manage multiple priorities.
• Excellent computer skills
• Creation of standard operating procedures and process improvement
• Ability to problem-solve, research and analyze data quickly.
• High sense of urgency and likes to meet deadlines.
• Exceptionally fast learner and problem solver
• Ability to solve complex business problems and build scalable processes.
• Strong process orientation and excellent communications skills
• Works well in a team environment
• Ability to manage multiple priorities and work in a fast-paced environment.
• Ability to remain calm and courteous under pressure and to navigate challenging situations.
• Ability to be trusted with sensitive, protected and highly confidential information.

Physical Requirements:

• Employees may be required to regularly stand, sit, talk, hear, reach, stoop, kneel, and use hands and fingers to operate a computer, telephone, and keyboard for an extended period.
• Must speak English and be able to communicate both verbally and in writing. Understand the speech of another person.
• Ability to work at a computer for long periods of time in a work day Work Environment:
• Moderate noise- business offices with computers, phones, printers, and light foot traffic. The above statements are intended to describe the general nature and level of work being performed by employees assigned to this job title.
• They are not intended to be interpreted as an exhaustive list of all responsibilities and duties of employees so assigned. Regular, predictable attendance is required as business demands dictate.

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