credentialing coordinator

Speak Viral

We are looking for a Credentialing Specialist to join our team and oversee administrative tasks dealing with our health facility&rsquo;s credentialing.Credentialing Coordinator responsibilities include maintaining and verifying files and tracking the expiration of certifications throughout the organization.Ultimately, you will work with different departments across our organization to ensure staff members have the necessary accreditations needed throughout the year.Responsibilities<ul><li>Identify discrepancies in information and conduct follow-ups</li><li>Present applications to the facility&rsquo;s Credentialing Committee</li><li>Assist customers with credentialing inquiries</li><li>Respond to health plan provider inquiries</li><li>Capture primary source documentation in computer databases</li><li>Ensure data is backed up</li><li>Follow compliance laws, regulations, procedures, and policies</li></ul>Requirements and skills<ul><li>Proven work experience as a Credentialing Coordinator or similar role</li><li>Excellent verbal and written communication skills</li><li>Expertise with Microsoft Office Word and Excel</li><li>Proficient touch-typing skills</li><li>Ability to focus for extended periods</li><li>Relevant training and/or certifications as a Credentialing Coordinator</li></ul>Benefits: Increment after Probation Annual Increment Free Meal/Tea Career GrowthJob Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Credentialing Specialist

Christus Health

Description Summary:The Coordinator Credentialing Senior serves as the first line of defense through the functions of providing for adequate and qualified staff. Under supervision of leadership, the Coordinator Credentialing Senior is responsible for the department. Duties include ensuring compliance with regulatory and accrediting agencies, interpreting standards, and identifying, recommending and implementing changes. This position serves as the liaison between administration and staff on matters such as medical staff credentialing. This includes, but is not limited to, verification of education and training, certification and clinical practice credentials. The Coordinator Credentialing Senior demonstrates leadership through the role of advisor to staff and administration in understanding and applying standards. This position is responsible for developing and maintaining all aspects of the credentialing function. Incumbent will demonstrate broad knowledge of the business and leadership ability to warrant role model status to others with relevant roles within the organization. The Coordinator Credentialing Senior is able to advise the medical staff leadership on matters of priority in an expeditious manner and can instruct them in the responsibilities of their positions with respect to credentialing and help bring them up to date on current issues involving regulatory agencies, clinical privileges, or standards of care. Must demonstrate sufficient empowerment skills to successfully assume and maintain at least one major project as assigned by administration. Assigned projects are strategic in nature and long term in responsibilities. The Credentialing Coordinator Senior should demonstrate strong organizational skills and assertiveness in problem solving.Responsibilities:<ul><li>Responsible for all aspects of credentialing</li><li>Serves as role model and mentor to others in interfacing relevant roles</li><li>Preceptor to others in duties related to credentialing</li><li>Cross trains other staff for major job responsibilities as appropriate for optimum functioning</li><li>Serves as liaison between staff and administration</li><li>Oversees credentialing activities</li><li>Precepts and mentors designated staff personnel</li><li>Coordinates staff with regulators</li><li>May facilitate staff meetings</li><li>May be responsible for the preparation of meetings, including production of agenda, documents for review and for personal review and preparation of staff in advance, as needed to facilitate informed participation.</li><li>May be responsible for accurate and timely recording of meeting minutes.</li><li>Assists staff in enforcing bylaws, rules and regulations, policies and procedures, and identifies /communicates the need for revisions and additions.</li><li>Tracks current licensure required for staff.</li><li>May record and track meeting attendance as required by staff bylaws for maintaining staff status.</li><li>May provide support for staff and administration for Due Process Proceedings by attending hearings and appeals meetings and recording proceedings.</li><li>Tracks monitoring/proctoring documentation necessary for the granting of special or new privileges to staff.</li><li>Updates the database for the credentials, and keeps computer system current.</li><li>May help coordinate staff functions</li><li>Follows the CHRISTUS Guidelines related to the Health Insurance Portability and Protected Health Information ACT (HIPAA), designed to prevent or detect unauthorized disclosure of Protected Health Information (PHI).</li><li>Collaborate with all other departments as appropriate and required to facilitate the completion of tasks/goals.</li><li>Responsible for all aspects of compliance with the standards of credentialing and accrediting bodies.</li><li>Communication, Coordination, Collaboration with all customers, internal and external</li><li>Responsible for at least one major project that contributes to the strategic initiatives of the department.</li><li>Serves as Liaison to staff in matters of credentialing and related issues.</li><li>Manages projects and timelines to achieve highest quality work within allotted period.</li></ul>Requirements:<ul><li>High School Diploma Required</li><li>3 Years Related Experience Preferred</li><li>Certified Provider Credentialing Specialist (CPCS) or Certified Medical Staff Coordinator (CMSC) Preferred</li></ul>Work Schedule: 5 Days - 8 HoursWork Type: Full Time

Coordinator Credentialing Senior - Credentialing

Macrise Tech Solutions

Location: Wapda Town, LahoreOne Behavioral Health and Alara Healthcare deliver high-quality outpatient and inpatient behavioral health services for adults and children across the Houston area. As our organization continues to grow, we are seeking a highly organized and detail-oriented Credentialing Specialist to ensure provider compliance, support efficient healthcare operations, and uphold the highest standards of patient care.Role OverviewThe Credentialing Specialist will be responsible for managing the complete lifecycle of provider credentialing and re-credentialing across multiple payers, networks, and platforms. This role requires a proactive mindset, exceptional attention to detail, and strong follow-up skills to ensure ongoing compliance with payer, regulatory, and hospital requirements. Your work will directly support timely authorizations, accurate billing, and uninterrupted patient care.Key ResponsibilitiesCredentialing &amp; Compliance<ul><li>Maintain, update, and organize provider credentialing files for both commercial and government payers.</li><li>Manage and monitor CAQH profiles, ensuring compliance with CMS and payer-specific standards.</li><li>Process initial credentialing and re-credentialing applications for Medicare, Medicaid, and private insurance networks.</li><li>Handle applications and renewals for professional licenses, DEA registrations, and controlled substance permits.</li><li>Complete government and regulatory revalidation processes within required timeframes.</li><li>Coordinate hospital credentialing activities, manage provider privileges, and maintain ongoing affiliations.</li></ul>Collaboration &amp; Support<ul><li>Partner closely with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer issues, and authorization challenges.</li><li>Ensure provider information is accurate and consistent across CAQH, PECOS, NPPES, CMS databases, and internal systems.</li><li>Maintain a centralized internal credentialing tracker, including provider credentials, expiration dates, and access details.</li><li>Provide administrative support for credentialing audits, compliance reviews, and related documentation as needed.</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs70,000.00 per monthAbility to commute/relocate:<ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul>Application Question(s):<ul><li>Willing to work as per US timing, Wapda Town, Lahore</li></ul>Experience:<ul><li>Credentialing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Work Location: In person

Medical Billing Credentialing Executive

Hiffey

Claims Med pioneers in Medical Billing for Healthcare providers in the United States. We are looking for fresh, energetic individuals who can not only add value to our firm, but also find endless opportunities in a growing firm. We are currently hiring individuals for our credentialing teams and looking for candidates(Preferably males) who are willing to learn and apply themselves in a short period of time- No Experience required.Job Description: Prepare, submit and track provider credentialing and re-credentialing applications. Maintain accurate provider information in CAQH, NPPES, PECOS and payer portals. Verify provider credentials Ensure compliance Coordinate site visits, address corrections and contract amendments as required by payers Maintain credentialing databases, spreadsheets and audit-ready files. Communicate regularly with providers, practice managers and insurance representatives regarding credentialing status Support facility credentialing and payer enrollment for new locations. Prepare reports on credentialing timelines, approvals, denials, and expirationsRequirements Night shift availability (7pm to 4am) Mondays to Fridays Graduation (required) English Proficiency is mustLocation Shaheed-e-Millat Rd, Karachi Paid training will be provided. Finalists will begin a 3-month probation period and will be re-evaluated before becoming permanent employees. Permanent employees enjoy several performance, and punctuality based bonuses, along with other perks.Please submit your resumes at hr@claimsmed.com and begin your journey of becoming an integral part of the Claims Med family.Job Type: Full-timePay: Rs40,000.00 - Rs45,000.00 per monthWork Location: In person

Credentialing Analyst

The Credentialing Executive is responsible for managing the provider enrollment and credentialing process with insurance companies, hospitals, and other healthcare organizations. This role ensures all providers are properly credentialed and enrolled to receive timely reimbursement for medical services, maintaining compliance with payer and regulatory requirements.Key Responsibilities:&middot; Prepare, review, and submit credentialing and re-credentialing applications for healthcare providers with commercial and government insurance payers (e.g., Medicare, Medicaid, BCBS, Aetna, UnitedHealthcare, Cigna, etc.).&middot; Maintain up-to-date records of providers in credentialing databases and online systems.&middot; Track the status of credentialing and enrollment applications, follow up with payers, and resolve any discrepancies or issues.&middot; Verify provider credentials, including licenses, board certifications, DEA, malpractice insurance, and other necessary documents.&middot; Coordinate with internal billing teams to ensure providers are properly linked and active with payers before billing.&middot; Update and maintain CAQH profiles, NPI registrations, and PECOS enrollments.&middot; Manage expirables (licenses, insurance, certifications) and notify providers of renewals.&middot; Ensure compliance with federal, state, and payer-specific regulations.&middot; Generate and maintain credentialing reports and dashboards.&middot; Communicate professionally with providers, practice managers, and insurance representatives.Required Qualifications:&middot; Bachelor&rsquo;s degree in Healthcare Administration, Business, or a related field (or equivalent work experience).&middot; 1&ndash;3 years of experience in medical credentialing, provider enrollment, or medical billing.&middot; Knowledge of CAQH, NPPES, PECOS, and payer portals.&middot; Strong understanding of commercial and government payer processes.&middot; Excellent communication and organizational skills.&middot; Proficiency in MS Office (Excel, Word, Outlook) and credentialing software.&middot; Ability to handle multiple tasks, prioritize, and meet deadlines.Preferred Qualifications:&middot; Experience with US-based healthcare systems or RCM/BPO companies.&middot; Certification in credentialing (e.g., CPCS, CPMSM) is a plus.&middot; Knowledge of medical billing and compliance regulations (HIPAA, CMS).Key Competencies:&middot; Attention to detail and accuracy&middot; Strong problem-solving and analytical skills&middot; Professional communication and interpersonal skills&middot; Time management and ability to work independently&middot; Team collaborationJob Type: Full-timePay: Rs30,000.00 - Rs50,000.00 per monthApplication Question(s):<ul><li>Will you be able to work night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Credentialing Executive

Description Summary:Responsible for coordination and oversight of the Medical Staff Services Department, including physician and allied health credentialing and re-credentialing and privileging, organizing and minutes taking at medical staff meetings, flow of information from medical staff committees through Administration, Medical Executive Committee, and the Governing Board. Assists with TJC survey preparation for the medical staff/leadership functions, including staff and medical staff education regarding accreditation standards. Works closely with medical staff leaders, hospital administration, and Risk Manager regarding medical staff and bylaws issues.Responsibilities:• The Credentials Verifications Office (CVO) medical Staff Coordinator is responsible for the coordination of medical Staff credentialing and privileging • The CVO Medical Staff Coordinator prioritizes the work processes and monitors the performance of the Credentialing SpecialistRequirements:<ul><li>Basic Computer Knowledge</li><li>Ability to communicate effectively, both verbally and written.</li><li>Must possess strong management, organization, communication, and computer skills; must demonstrate good interpersonal and analytical skills and the ability to work under stress and maintain confidentiality.</li><li>Requires a minimum of 3-5 years' experience in a medical staff office or related health care environment and has effective knowledge of TJC and TDH Standards.</li><li>High school diploma or equivalent.</li></ul>Work Schedule: 8AM - 5PM Monday-FridayWork Type: Full Time

Coordinator Medical Staff-Med Staff Administration-Full Time

GRMAC Pvt ltd

Job Title: Credentialing Executive (Healthcare Process)Location: Chennai Experience: 1&ndash;5 years Industry: Health Care / Medical ServicesJob Description: Responsible for verifying and processing healthcare professionals&rsquo; credentials, licenses, and documents as per company and client standards. Ensure accuracy and timely completion of credentialing and re-credentialing activities.Key Responsibilities:<ul><li>Collect and verify doctors&rsquo;/providers&rsquo; documents and licenses</li><li>Update and maintain credentialing databases</li><li>Coordinate with healthcare providers and insurance networks</li><li>Ensure compliance with regulatory and organizational policies</li></ul>Requirements:<ul><li>Good communication skills</li><li>Attention to detail</li><li>Basic knowledge of healthcare documentation preferred</li><li>Experienced candidates can apply</li></ul>Job Types: Full-time, PermanentPay: ₹20,000.00 - ₹30,000.00 per monthBenefits:<ul><li>Health insurance</li><li>Provident Fund</li></ul>Work Location: In person

Credentialing Specialist (Healthcare Process)

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