Credentials Coordinator (Remote)

CREDENTIAL COORDINATOR - Remote position

JOB SUMMARY/OBJECTIVE:

The Credentialing Coordinator is responsible for coordinating provider credentialing and privileging activities in support of Preservation of the Force and Family (POTFF) operations and other Choctaw Global (CG) programs. This role ensures healthcare and ancillary professionals meet all regulatory, contractual, and organizational requirements to provide services in their specialized area. The Credentialing Coordinator collects credentialing documents, uploads documents in the MD-Staff approved credentialing software system, performs primary source verifications, maintains accurate credentialing records, and ensures compliance with applicable standards (e.g. National Committee for Quality Control (NCQA), Joint Commission, Department of Defense (DoD, Department of War (DoW) and Defense Health Agency (DHA) requirements. This position serves as a liaison between providers, internal stakeholders, and external agencies to support timely, accurate, and audit-ready credentialing processes.

PRIMARY RESPONSIBILITIES:
• Maintain full-cycle credentialing and re-credentialing processes for clinical and ancillary providers, including primary source verification of licensure, education, training, certifications, and work history.
• Ensure compliance with federal, state, DoD/DoW/DHA accreditation standards (e.g., National Practitioner Data Bank (NPDB) queries, sanction screenings, background checks).
• Maintain accurate and up-to-date provider files and credentialing databases.
• Prepare and submit credentialing packets to military treatment facilities and/or governing bodies.
• Track and manage expirable(s) (licenses, certifications such as BLS/ACLS/PALS), and ensure timely renewals.
• Coordinate privileging and appointment processes in collaboration with medical treatment facility personnel.
• Communicate with providers and third-party entities to obtain missing or incomplete documentation.
• Conduct audits of credentialing files to ensure accuracy and regulatory compliance.
• Collect, analyze and report data to internal and external stakeholders making recommendations for process improvement.• Generate reports on credentialing status, timelines, and compliance metrics.
• Stay current on credentialing regulations, standards, and best practices.
• Additional job duties as assigned.

MINIMUM QUALIFICATIONS:
• Knowledge of credentialing processes, including primary source verification and regulatory compliance.
• Familiarity with healthcare accreditation standards and credentialing best practices.
• Strong attention to detail and ability to manage high-volume, deadline driven workflows.
• Proficiency in Microsoft Office and credentialing and/or database systems.

REQUIRED EDUCATION & EXPERIENCE:
• High school diploma or equivalent.
• Minimum one (1) year of credentialing experience in a healthcare or government contracting environment.
• Experience processing credentialing applications, verifications, and compliance documentation.

PREFERRED:
• Associate's degree in healthcare administration, business administration, or related field.
• Experience with DoD/DoW/DHA credentialing systems and/or military treatment facility processes.
• Credentialing certification (e.g., Certified Provider Credentialing Specialist (CPCS)).
• Familiarity with NCQA and/or Joint Committee Standards.
• Experience with credentialing software platforms.

COMPETENCIES:
• Detail-Oriented
• Organization
• Compliance
• Communication
• Accountability
• Time Management
• Problem Solving
• Confidentiality

PHYSICAL REQUIREMENTS:
• Ability to perform job duties within a standard office environment, including extended periods of desk work and computer use.

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. EEO/AAP STATEMENT: We acknowledge and honor the fundamental value and dignity of all individuals. We pledge ourselves to craft and maintain an environment that respects diverse traditions, heritages, and experiences. Choctaw 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.

EEO/AAP STATEMENT: We acknowledge and honor the fundamental value and dignity of all individuals. We pledge ourselves to craft and maintain an environment that respects diverse traditions, heritages, and experiences. Choctaw 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.