provider credentialing coordinator

Encore Wound Care

Job Overview The Clinical Document Coordinator is responsible for supporting provider credentialing and compliance activities by maintaining accurate records, monitoring licensure and certification expirations, and serving as a liaison between providers and the credentialing company. This role ensures all provider documentation is current, organized, and compliant with regulatory and organizational requirements.Responsibilities<ul><li>Licensure &amp; Certification Tracking</li><li>Monitor and track expiration dates for all provider licenses, certifications, and registrations</li><li>Proactively notify providers of upcoming expirations and renewal requirements and collect updated documentation</li><li>Maintain accurate and up-to-date records of all licensure documentation</li><li>Verify insurance coverage and perform insurance eligibility checks using managed care protocols</li><li>Prepare and maintain accurate medical records in compliance with HIPAA regulations and organizational policies</li><li>CAQH Profile Management</li><li>Create, update, and maintain provider profiles within CAQH</li><li>Ensure all attestations are completed on time</li><li>Upload and verify accuracy of provider documents within the CAQH system</li><li>Document Management &amp; Compliance</li><li>Organize and maintain digital files for all provider credentials, including licenses, malpractice insurance, DEA, and certifications</li><li>Ensure all required documentation is current and audit-ready</li><li>Assist with internal and external audits by providing requested documentation</li><li>Credentialing Coordination</li><li>Serve as the primary point of contact between providers and the credentialing company</li><li>Track credentialing application statuses and follow up as needed</li><li>Communicate any missing or incomplete items to providers promptly</li><li>Administrative Support</li><li>Maintain tracking logs and spreadsheets related to credentialing and compliance</li><li>Assist with onboarding new providers by gathering and organizing required documentation</li><li>Support ongoing compliance initiatives and process improvements</li></ul>Skills<ul><li>2+ years of administrative experience, preferably in healthcare or credentialing</li><li>Experience with CAQH and provider credentialing processes strongly</li><li>Experience with managed care processes and insurance verification procedures</li><li>Familiarity with HIPAA regulations to safeguard patient privacy and confidentiality</li><li>Previous medical office experience preferred for seamless integration into clinical workflows</li><li>Excellent organizational skills with attention to detail in record-keeping and documentation</li><li>Ability to communicate effectively with healthcare providers and internal teams, and 3rd party groups</li></ul>This role is perfect for motivated individuals eager to grow within the healthcare administration field. Join us in delivering exceptional patient care through efficient administrative support!Pay: $18.00 - $22.00 per hourBenefits:<ul><li>401(k)</li><li>401(k) matching</li><li>Dental insurance</li><li>Health insurance</li><li>Paid time off</li><li>Vision insurance</li></ul>Work Location: In person

Clinical Document Coordinator

DocGo

<div>Job Title: Coordinator, Licensing &amp; Credentialing
Location: Remote
Employment Type: Temporary, open-ended position, part-time up to 40 hours a week - some weekends and evenings needed
Hourly Rate: $20.00 - $27.00/hour, based on experience on a W2<h2 class="jobSectionHeader">
Description</h2><div>
We&rsquo;re looking for a detail-oriented Credentialing Specialist to support provider
onboarding and compliance across a multi-state telehealth environment. This role is critical to ensuring our clinicians are fully vetted, credentialed, and ready to safely deliver care.
Key Responsibilities:<ul><li>
Manage end-to-end credentialing for providers from intake through approval</li><li>
Build and maintain provider profiles in Modio</li><li>
Track workflows and progress in JIRA</li><li>
Perform primary source verification (licenses, education, board certs, DEA, etc.)</li><li>
Run sanction screenings (OIG, SAM, NPDB) and complete compliance checks</li>
Partner cross-functionally to move providers from Credentialing Approved<li> Clear to Practice (CTP)</li><li>
Communicate with providers to ensure timely application completion</li><li>
Assist with the onboarding process for new clinicians</li><li>
Manage the end-to-end medical licensing process.</li><li>
Assist with the onboarding process for new clinicians</li><li>
Ensure timely acquisition and renewal of licenses for all SteadyMD physicians and nurses.</li><li>
Maintain compliance with state and federal licensing regulations.</li><li>
Act as the primary liaison with medical boards and regulatory agencies.</li><li>
Update internal teams on changes in licensing laws and requirements.</li></ul></div><h2 class="jobSectionHeader">
Preferred Requirements</h2><div><ul><li>
2+ years of credentialing and/or licensing experience preferred (telehealth or multi-state preferred)</li><li>
Strong understanding of primary source verification &amp; compliance requirements</li><li>
Experience with credentialing platforms (Modio preferred)</li><li>
Highly organized with strong attention to detail</li><li>
Comfortable managing multiple providers and deadlines</li><li>
Excellent organizational and communication skills.</li><li>
Ability to work collaboratively with cross-functional teams.</li><li>
Working knowledge of current IMLC, FSMB, and reciprocity states</li><li>
Experience managing licensing for physicians, and nurses across all 51 states.</li></ul></div>
EEO/AAP Statement: DocGo is an equal opportunity employer. We acknowledge and honor the fundamental value and dignity of all individuals. We pledge ourselves to crafting and maintaining an environment that respects diverse traditions, heritages, and experiences. DocGo is an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
The above-noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the applicant a general sense of the responsibilities and expectations of this position. As the nature of business demands change so, too, may the essential functions of the position.</div>

Coordinator, Licensing & Credentialing

Macrise Tech Solutions

The Credentialing Specialist is responsible for managing the complete lifecycle of provider credentialing and re-credentialing across various insurance networks, payers, and credentialing platforms. This role requires a proactive, detail-oriented professional with strong follow-up capabilities to ensure ongoing regulatory compliance, uninterrupted provider participation, and efficient billing and authorization workflows. The position plays a critical role in supporting operational efficiency and ensuring accurate, timely reimbursements.Key ResponsibilitiesCredentialing &amp; Compliance<ul><li>Maintain, organize, and regularly update provider credentialing records for both commercial and government payers.</li><li>Oversee and manage CAQH profiles to ensure compliance with CMS regulations and payer-specific credentialing standards.</li><li>Process initial credentialing, re-credentialing, and payer enrollment applications for Medicare, Medicaid, and commercial insurance networks.</li><li>Manage applications, renewals, and documentation related to professional licenses, DEA registrations, and controlled substance certifications.</li><li>Complete provider revalidation processes with government and regulatory bodies within required timelines.</li><li>Coordinate hospital credentialing activities, including managing provider privileges and maintaining active affiliations.</li></ul>Collaboration &amp; Operational Support<ul><li>Work closely with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer concerns, and authorization delays.</li><li>Ensure provider data is accurate and consistent across CAQH, PECOS, NPPES, CMS databases, and internal systems.</li><li>Maintain a centralized credentialing tracker, including provider credentials, expiration dates, payer participation status, and system access information.</li><li>Provide administrative support for credentialing audits, compliance reviews, and regulatory documentation as required</li></ul>Job Type: Full-timePay: Rs45,000.00 - Rs80,000.00 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 the night shift in 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

Payer Enrollment & Credentialing Specialist

Jawa Health Care

Job Title: Credentialing Expert Department: Credentialing / RCM Industry: Healthcare / DME Experience: 1&ndash;3 years (Fresh + Experienced can apply)Job SummaryWe are looking for a detail-oriented Credentialing Expert to manage provider enrollment, re-credentialing, and compliance with insurance networks. The ideal candidate will ensure timely onboarding of providers and maintain accurate credentialing records.Key Responsibilities<ul><li>Handle provider enrollment with Medicare, Medicaid, and commercial payers</li><li>Manage CAQH profiles (creation, updating, attestation)</li><li>Submit and track credentialing and re-credentialing applications</li><li>Follow up with insurance companies for application status</li><li>Maintain provider documentation (licenses, NPI, DEA, malpractice insurance)</li><li>Ensure compliance with payer requirements and deadlines</li><li>Resolve credentialing-related issues and delays</li><li>Maintain accurate records in credentialing systems</li></ul>Requirements<ul><li>Bachelor&rsquo;s degree (preferred)</li><li>Knowledge of US healthcare credentialing process</li><li>Familiarity with CAQH, PECOS, NPPES</li><li>Strong communication and follow-up skills</li><li>Good command of MS Excel and documentation</li></ul><ul><li>Shift: Night shift (US timing)</li><li>6pm to 3am</li><li>Monday to Friday</li><li>Saturday Sunday off</li><li>Location: On-site</li><li>Salary: Market competitive</li><li>Perks: Growth, training,</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

Credentialing Expert

Job Summary:The Credentialing Executive is responsible for managing the end-to-end provider credentialing and re-credentialing process with insurance payers, ensuring compliance with regulatory standards and maintaining accurate provider records.Key Responsibilities:<ul><li>Handle provider enrollment and credentialing with Medicare, Medicaid, and commercial insurance payers</li><li>Prepare and submit credentialing applications (initial, revalidation, and re-credentialing)</li><li>Maintain and update CAQH profiles and ensure data accuracy</li><li>Track application status and follow up with payers for approvals</li><li>Maintain a database of provider credentials including licenses, certifications, and malpractice insurance</li><li>Ensure compliance with NCQA, CMS, and payer guidelines</li><li>Coordinate with internal departments (billing, compliance, operations)</li><li>Manage re-credentialing timelines and ensure timely renewals</li><li>Resolve credentialing-related issues and denials</li><li>Maintain proper documentation and audit-ready files</li></ul>Required Qualifications:<ul><li>Bachelor&rsquo;s degree (Healthcare Administration preferred)</li><li>1&ndash;3 years of experience in medical credentialing/enrollment (DME experience preferred)</li><li>Strong knowledge of Medicare, Medicaid, and commercial payer processes</li><li>Experience with CAQH, PECOS, NPPES systems</li><li>Good communication and follow-up skills</li></ul>Skills Required:<ul><li>Attention to detail</li><li>Strong organizational skills</li><li>Time management and deadline handling</li><li>Knowledge of healthcare compliance regulations</li><li>Proficiency in MS Office / Excel</li></ul>Preferred Qualifications:<ul><li>Experience in DME (Durable Medical Equipment) credentialing</li><li>Familiarity with US healthcare system</li><li>Prior experience working in night shift (for US-based processes)</li></ul>KPIs / Performance Metrics:<ul><li>Application turnaround time</li><li>Approval rate from payers</li><li>Accuracy of submitted applications</li><li>Re-credentialing completion rate</li><li>Compliance audit results</li></ul>Work Timings (Optional &ndash; Customize):<ul><li>Night Shift (US Time Zone)</li><li>Example: 6:00 PM &ndash; 3:00 AM (PKT)</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

Credentialing Executive Medical Billing

Mount Sinai Health System

<div>Description
Position Title:
Medical Staff Credentialing Coordinator-HSO Medical Staff Services-Mount Sinai Health System-Remote-Full Time-Days
Position Summary:
The Medical Staff Credentialing Coordinator is responsible for coordinating the credentialing and re-credentialing process for all practitioners applying for medical or allied health staff membership and/or clinical privileges. Provide support for all credentialing functions within the Medical Staff Office.
Responsibilities<ul><li>
Coordinates the application and reapplication process for all practitioners who are seeking to be granted membership and or clinical privileges at MSHS, including but not limited to: verifying all relevant information via the primary source; reviewing and analyzing potential issues and concerns; and preparing files for routing to the appropriate medical staff leaders, committees and the governing body.</li><li>
Acts as customer service liaison coordinating communications between the applicant, human resources, and the clinical department as it relates to the credentialing process.</li><li>
Evaluates applicants credentials in accordance to credentialing and privileging policies in order to ensure compliance with medical staff bylaws and accrediting agencies (e.g., The Joint Commission, CMS, NCQA, etc.).</li><li>
Ensures all credentialing deadlines are clearly communicated, credentials are maintained for all providers in a timely manner and ensures full compliance with the medical staff credentialing policies and procedures.</li><li>
Maintains all credentialing related databases in accordance to medical staff policies and procedures.</li><li>
Assists in tracking quality and performance improvement data for credentialed practitioners.</li><li>
Supports all other functions of the medical staff office and performs other duties as assigned by department leadership.</li></ul>
Qualifications<ul><li>
Bachelors Degree in a health care related field or equivalent work experience.</li><li>
2 years minimum of hospital-based credentialing and privileging experience is required.</li><li>
Experience in an academic medical center, multi-entity health system and/or a CVO is strongly preferred.</li><li>
NAMSS Certified Provider Credentialing Specialist (CPCS), Required or must obtain within one year of hire.</li></ul> 
Non-Bargaining Unit, 542 - HSO Medical Staff Services - MSH, Mount Sinai Hospital
Employer Description
Strength through Unity and Inclusion 

The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai&rsquo;s unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. 

At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. 

About the Mount Sinai Health System: 

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time &mdash; discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients&rsquo; medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News &amp; World Report's Best Hospitals, receiving high &quot;Honor Roll&quot; status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News &amp; World Report&rsquo;s &ldquo;Best Children&rsquo;s Hospitals&rdquo; ranks Mount Sinai Kravis Children's Hospital among the country&rsquo;s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek&rsquo;s &ldquo;The World&rsquo;s Best Smart Hospitals&rdquo; ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. 

Equal Opportunity Employer 

The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. 

Compensation
The Mount Sinai Health System (MSHS) provides salary ranges that comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $66482.07 - $74369.26 Annually. Actual salaries depend on a variety of factors, including experience, education, and operational need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.</div>

Medical Staff Credentialing Coordinator-HSO Medical Staff Services-Mount Sinai Health System-Remote-Full Time-Days

eServMD Pvt. Ltd.

eServMD Pvt Ltd is a service provider company based in Islamabad Pakistan providing services to US-based companies and clients in the field of Electronic Medical Records (EMR), Medical Practice Management, Medical Billing, Real Estate, Accounts &amp; Finance.We are seeking experienced and detail-oriented Credentialing Executive to join our team.Primary Responsibilities:<ul><li>Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications</li><li>Maintain internal provider grid to ensure all information is accurate and logins are available</li><li>Update each provider&rsquo;s CAQH database file timely according to the schedule published by CMS</li><li>Help medical providers to apply or renewal of medical professional licenses; DEA and Controlled Substance etc.</li><li>Complete revalidation requests issued by government payers</li><li>Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid Complete re-credentialing applications for commercial payers</li><li>Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing</li><li>Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases</li></ul>Requirements<ul><li>1-2 years prior Experience in US Medical Credential</li><li>Minimum Bachelor&rsquo;s Degree in Commerce/Finance/Arts/ Pharmacy/ Microbiology or related</li><li>Excellent in English communication skills both verbal &amp; written, spoken English in American pronunciation is desired</li><li>Good Command over Excel, word and health industry related software tools</li><li>Excellent Organizational, Analytical skills and able to adapt to changing situations</li><li>Proven Knowledge of basic medical terminologies such as coding-ICD10, CPT &amp; HCPC</li><li>Experienced in Managing the Overall Revenue Cycle</li><li>Knowledge about Data Conversion and EMR implementation</li><li>Knowledge about enrollment &amp; credentialing and EDI &amp; ERA/EFT setup</li></ul>Job Timings: 5:00 PM to 2:00 AMJob Type: Full-timeAbility to commute/relocate:Job Type: Full-timeWork Location: In person

Sr. Credentialing Executive

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