Credentialing Coordinator

Job Summary and Responsibilities

As a Credentialing Professional, you will be responsible for coordinating the credentialing, re-credentialing, and payer enrollment process for providers in accordance with delegated credentialing agreements, policies and procedures, industry best practices, and regulatory requirements.

Every day you will manage daily credentialing operations, including the resolution of non-responsive providers. You will be expected to work collaboratively with various clinic managers and the hospital medical staff office to ensure the successful and timely completion of the delegated credentialing and re-credentialing process.

To be successful in this role, you must demonstrate a comprehensive understanding of credentialing regulations and processes, possess strong organizational and communication skills, and effectively manage complex administrative tasks to ensure provider compliance and efficient operational flow.

• Maintains up-to-date physician database of all applications, enrollment status, demographics, medical licenses, Drug Enforcement Administration certificates, professional liability insurance, etc.

• Responsible for the accuracy and integrity of data entered into the credentialing database system.

• Assist in designing/compiling other data supporting various statistics utilized internally to monitor operations.

• Responsible for continuous collection of information required to comply with delegated agreements and credentialing policies.

• Conducts credentialing database training for new hires and refresher training for existing staff. Provides input for training materials and job aids.

• Reviews applications and other data sources for accuracy and completeness before submitting to Health Plan.

We are offering $10k relocation assistance to new hires who meet the eligibility requirements.

Job Requirements

Required

• High School Graduate or GED

• Knowledge of commonly used concepts, practices, and procedures used in health care and physician credentialing

• Builds successful customer relationships. Excellent oral and written communication skills are essential

• Works well under stress and with shifting priorities

• Knowledge of NCQA standards and Joint Commission standards

• Intermediate Google software skills

• Proficient with credentialing software system

• Medical Terminology

Preferred

• Three (3) years of experience in a Medical Staff Services, CVO or other hospital administrative department. Comparable healthcare work experience may be considered

• Bachelors

• Certified Provider Credentialing Specialist (CPCS)

Where You'll Work

Are you ready to join a healthcare family where your values align with ours? At Dignity Health - Yavapai Regional Medical Center (DH-YRMC), now a proud part of CommonSpirit Health, a not-for-profit integrated healthcare provider, our core mission guides every decision and every interaction.

Here, you'll discover more than just a job; you'll find rewarding career opportunities across a comprehensive network of inpatient and outpatient services. From a vibrant community hospital, YRMC has grown into a leading regional healthcare system.

Today, that means you could be making an impact at:

• Two state-of-the-art acute care hospitals

• A robust network of primary and specialty care clinics

• Modern outpatient health and wellness services

• Acclaimed cardiac diagnostic centers

• Advanced outpatient medical imaging facilities

Elevate your career without sacrificing your quality of life. As you grow with YRMC, you'll find the Prescott area isn't just a place to work - it's an inspiring community designed for living, thriving, and embracing the outdoors. Imagine a charming blend of bygone appeal and modern amenities, coupled with four distinct seasons and nearly year-round sunshine perfect for every adventure.

Say hello to a relaxed lifestyle that empowers you to prioritize both your professional growth and family time. YRMC extends this inviting spirit within our walls, fostering a strong sense of family, and belonging among our team members.

Come experience the exceptional quality of life that YRMC and Prescott offer. Work at the heart of #hellohumankindness and discover where your career and well-being truly connect.

• Dignity Health now offers an Education Benefit program for benefit-eligible employees after 180 days. This program provides debt relief and student loan assistance to help you achieve your goals. Full-time employees can receive up to $18,000 over five years, while part-time employees can receive up to $9,000. Join our team at Dignity Health to take advantage of this amazing opportunity!

Pay Range

$24.33 - $36.19 /hour

We are an equal opportunity/affirmative action employer.