Credentialing Coordinator

Credentialing Coordinator

Credentialing Verification Organization - Plano, TX Full Time | Hybrid | Supporting our Outpatient Division Starting Pay Rate - $17/hour Location: Credentialing OP Division 3801 15th Street Building A, Suite A300 Plano TX 75075 Schedule: MondayFriday | 7:30 am - 4:30 pm (CT) Benefits: Diverse and comprehensive benefits package Accruable Paid Time Off (PTO) Paid holidays 401(k) with company match Health, dental, vision, and life insurance Short- and long-term disability Extended Illness Days (EID) Personal and family medical leave Access to campus walking trails and outdoor rest areas Thorough orientation and strong cross-department collaboration opportunities

About the Opportunity

Select Medical is seeking a detail-oriented Credentialing Coordinator to support our Credentialing Manager with the full credentialing and re-credentialing process for providers across our outpatient facilities. This role plays a key part in ensuring compliance, accuracy, and smooth onboarding of practitioners.

Does This Sound Like You?

• You enjoy working behind the scenes in healthcare administration.
• You want to continue your career in provider credentialing or another related healthcare role
• You thrive in collaborative, innovative team environments
• You want to work for an organization devoted to helping others

If so, this could be an excellent opportunity for you!

Watch our video to see what it's like to work at Select Medical. We'd love for you to join our team!

Responsibilities

Conducts credentialing and re-credentialing in compliance with NCQA and HIPAA standards for internal and external clinicians. Research and obtain verifications of practitioners' credentials to complete internal and external credentialing requirements.

• Manage state-specific credentialing activities for providers in our outpatient facilities.
• Prepare and process all credentialing documentation.
• Update and maintain current and accurate practitioner files and database.
• Track and report practitioner changes to appropriate parties.
• Communicate with practitioners, data banks, state licensing and regulatory bodies, educational programs, health plans, and other company divisions.
• Coordinate with health plans to provide practitioner credentialing documentation as required.
• Participate in activities associated with health plan site audits and Credentialing Committee meetings.
• Coordinate training and educational requirements for credentialing staff.
• Provide routine updates and status reports for health plans and other divisions within the company.
• Maintain confidentiality of practitioner information.
• Collaborate with team members to support process improvement and the development of policies and procedures.
• Provide routine updates and status reports for health plans and other divisions within the company.
• Coordinated efforts with other credentialing and Managed Care personnel.
• Troubleshoot with internal business operations and Managed Care contracting to resolve accounts receivable delays due to credentialing issues.
• Participate in the development and coordination of departmental CQI initiatives. Perform other duties as assigned.

Qualifications

Minimum Qualifications At least 2 years of experience in provider credentialing or other related healthcare field Proficient in Windows (Word, Excel, and Access). Ability to be professionally assertive with internal and external partners to be influential in finding resolutions. Strong oral and written communication skills with the ability to interact professionally and positively within all levels of the organization. Detail-oriented with good organizational skills and the ability to maintain accuracy while meeting deadlines and production requirements. Excellent interpersonal skills and commitment to quality improvement. Professional with the ability to work well independently as well as collaboratively with a team.

Preferred Qualifications Prior credentialing experience. Knowledge of credentialing processes, terminology, and NCQA standards. Strong analytical skills, including process improvement and problem resolution.

Additional Data

Select Medical values work-life balance and strives to offer a supportive, fulfilling workplace. Our employees enjoy meaningful careers complemented by benefits and programs that support their well-being both inside and outside the workplace. Equal Opportunity Employer, including Disabled/Veterans