Credentialing Coordinator
Washington Health Medical Group
20 hours ago
Full-time
On-site
Fremont, California, United States
$29 - $35 USD hourly
Registered Nurse
Summary/Objective
Reporting to the Director of Human Resources and Administrative Services provides support to the Washington Township Medical Foundation Credentialing Department.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Process initial credentialing and re-credentialing applications for physicians, NPs and Pas
Verify licenses, certifications, education, work history, and malpractice coverage through Healthguard for primary source verification
Maintain credentialing databases (e.g., CAQH, payer portals) and ensure timely updates
Track expiration dates for licenses, DEA registrations, and certifications; proactively follow up to prevent lapses
Maintain Rosters
Administrator for Payors, including, but not limited to: granting/removing employee access, password resets, etc.
Prepare credentialing files for internal committee review and payer submission
Communicate with providers to collect required documentation
Ensure compliance with NCQH and state/federal regulations
Respond to inquiries from health plans, hospitals, and internal stakeholders regarding provider status
Maintain confidentiality of sensitive provider information
Back up to the Executive Assistant/Manager of Administration.
Other duties as assigned.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.
Qualifications and Education Requirements Must have at least 6 months to a year of related credentialing experience.
Proficiency in Microsoft Office Suite
Must have strong organizational skills to effectively prioritize, coordinate, perform and complete multiple duties and assignments concurrently and in a timely manner.
Must have the ability to communicate effectively and handle sensitive/confidential information.
Knowledge of and proficiency in English composition, spelling, grammar, punctuation, and basic math principles.
Competencies Business Acumen
Interpersonal Relationships
Change Agent
Collaboration Skills
Communication Proficiency
Decision Making
Initiative
Leadership
Problem Solving/Analysis
Job Type: Full-time
Salary: $29.00-$35.00 per hour
Benefits:
401(k)
401(k) matching
Dental insurance
Disability insurance
Employee assistance program
Flexible spending account
Health insurance
Life insurance
Paid time off
Parental leave
Vision insurance
Schedule:
Monday to Friday
Work Location: One location
Reporting to the Director of Human Resources and Administrative Services provides support to the Washington Township Medical Foundation Credentialing Department.
Essential Functions
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Process initial credentialing and re-credentialing applications for physicians, NPs and Pas
Verify licenses, certifications, education, work history, and malpractice coverage through Healthguard for primary source verification
Maintain credentialing databases (e.g., CAQH, payer portals) and ensure timely updates
Track expiration dates for licenses, DEA registrations, and certifications; proactively follow up to prevent lapses
Maintain Rosters
Administrator for Payors, including, but not limited to: granting/removing employee access, password resets, etc.
Prepare credentialing files for internal committee review and payer submission
Communicate with providers to collect required documentation
Ensure compliance with NCQH and state/federal regulations
Respond to inquiries from health plans, hospitals, and internal stakeholders regarding provider status
Maintain confidentiality of sensitive provider information
Back up to the Executive Assistant/Manager of Administration.
Other duties as assigned.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Physical Demands
While performing the duties of this job, the employee is regularly required to talk or hear. This is largely a sedentary role; however, some filing is required. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.
Qualifications and Education Requirements Must have at least 6 months to a year of related credentialing experience.
Proficiency in Microsoft Office Suite
Must have strong organizational skills to effectively prioritize, coordinate, perform and complete multiple duties and assignments concurrently and in a timely manner.
Must have the ability to communicate effectively and handle sensitive/confidential information.
Knowledge of and proficiency in English composition, spelling, grammar, punctuation, and basic math principles.
Competencies Business Acumen
Interpersonal Relationships
Change Agent
Collaboration Skills
Communication Proficiency
Decision Making
Initiative
Leadership
Problem Solving/Analysis
Job Type: Full-time
Salary: $29.00-$35.00 per hour
Benefits:
401(k)
401(k) matching
Dental insurance
Disability insurance
Employee assistance program
Flexible spending account
Health insurance
Life insurance
Paid time off
Parental leave
Vision insurance
Schedule:
Monday to Friday
Work Location: One location