Credentialing Coordinator

Description

POSITION PURPOSE

We are seeking a highly organized and detail-oriented Credentialing Coordinator to join our team. In this role, you will be responsible for obtaining and maintaining insurance credentialing for all healthcare providers, ensuring compliance with necessary requirements for participation with insurance payers. You will manage the application process, track renewal deadlines, facilitate smooth provider enrollment, and cultivate strong relationships with insurance companies. The ideal candidate will have excellent communication skills, exceptional attention to detail, and the ability to efficiently manage multiple tasks in a fast-paced environment.

Essential Functions & Basic Duties

• Processing initial credentialing and recredentialing applications for healthcare providers, ensuring compliance with regulatory and organizational standards.
• Verifying and updating provider information, including licenses, certifications, education, work history, and malpractice coverage.
• Ensuring compliance with all applicable laws, regulations, and accreditation standards.
• Monitoring and tracking expiration dates for licenses, certifications, and professional liability insurance and notifying providers of renewal requirements.
• Facilitating enrollment and participation with insurance networks and government programs (e.g., Medicare, Medicaid).
• Maintaining payer contracts and assisting with resolving payer-related credentialing issues.
• Maintaining accurate and up-to-date records in credentialing databases and systems.
• Generating and distributing reports on credentialing statuses and deadlines as needed.
• Serving as the primary point of contact for providers, payers, and other stakeholders regarding credentialing matters.
• Collaborating with internal departments to support timely provider onboarding and compliance.
• May perform other related and non-related duties, as assigned.
  
  

COMPETENCIES

Initiative

• Volunteers readily.
• Undertakes self-development activities.
• Seeks increased responsibilities.
• Takes independent actions and calculated risks.
• Looks for and takes advantage of opportunities.
• Asks for and offers help when needed.
  
  

Innovation

• Displays original thinking and creativity.
• Meets challenges with resourcefulness.
• Generates suggestions for improving work.
• Develops innovative approaches and ideas.
• Presents ideas and information in a manner that gets others’ attention.
  
  

Motivation

• Sets and achieves challenging goals.
• Demonstrates persistence and overcomes obstacles.
• Measures self against standard of excellence.
• Takes calculated risks to accomplish goals.
  
  

Problem Solving

• Identifies and resolves problems in a timely manner.
• Gathers and analyzes information skillfully.
• Develops alternative solutions.
• Works well in group problem-solving situations.
• Uses reason, even when dealing with emotional topics.
  
  

Planning/Organizing

• Prioritizes and plans work activities.
• Uses time efficiently.
• Plans for additional resources.
• Sets goals and objectives.
• Organizes or schedules other people and their tasks.
• Develops realistic action plans.
  
  

Teamwork

• Balances team and individual responsibilities.
• Exhibits objectivity and openness to others’ views.
• Gives and welcomes feedback.
• Contributes to building a positive team spirit.
• Puts success of team above own interests.
• Able to build morale and group commitments to goals and objectives.
• Supports everyone’s efforts to succeed.
  
  

PHYSICAL DEMANDS

While performing the duties of this job, the employee is frequently required to talk or hear. The employee is regularly required to walk; sit; use hands to finger, handle, or feel; and reach with hands and arms. The employee is occasionally required to stand and stoop, kneel, crouch, or crawl. The employee must occasionally lift and/or move up to 50 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and ability to adjust focus.

The noise level in the work environment is moderately quiet.

Requirements

QUALIFICATIONS

Education/ Certification

• Bachelor’s Degree from a four-year accredited college or university preferred.
  
  

Experience/ Knowledge Required

• Two years of successful experience in a similar position preferred.
  
  

Skills/ Abilities

• Ability to communicate effectively and professionally with a wide variety of people.
• Strong organizational skills with attention to detail and accuracy.
• Basic computer skills which include a working knowledge of databases, word processing, spreadsheets, and Internet software.
• Ability to handle multiple tasks in a very busy environment.
• Ability to read and interpret documents such as safety rules, policies, and other company documents. Ability to write routine reports and correspondence. Ability to communicate effectively with co-workers and other professionals outside of the organization.
• Ability to add, subtract, multiply, divide, in all units of measure using whole numbers, common fractions, and decimals.
• Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form.
• Ability to deal with problems involving several concrete variables in standard situations.
  
  

Work Environment

• This is a full-time, on-site position.
  
  

Travel Requirements

Minimal travel is required for this position; this travel should not include transporting students/clients.

ACCESS drivers are required to maintain a valid Driver’s License, current auto liability insurance and registration, a clean driving record, and physical ability to drive to local locations throughout Arkansas.