Credentialing Coordinator | Full Time

Job Description

Job Description

Who we are:

Peterson Health is an independent, not-for-profit healthcare organization located in Kerrville, Texas, in the heart of the Texas Hill Country. Recognized as one of the nation's Top 20 Rural and Community Hospitals and the only Texas hospital to earn this distinction, Peterson is also Magnet® designated for nursing excellence and has been named one of Modern Healthcare's Best Places to Work in Healthcare for six consecutive years. Together, these achievements reflect our commitment to exceptional, compassionate, patient-centered care and a culture where team members thrive.

Shift Information:

This position is Full-Time

What we offer:

Health Insurance

401(k)

Dental Insurance

Vision Insurance

Paid time off

Tuition Reimbursement | HPSA Designated

Employee Education Scholarships

Employee Referral Program

Merit Increases

Free access to a beautiful onsite fitness facility

What you will do:

The Credentialing Coordinator is responsible for performing credentials verification for members of Peterson Regional Healthcare Network (PRHCN), and employed/contracted providers of Peterson Health to ensure compliance with standards set forth by the National Committee Quality Assurance (NCQA), Center for Medicare and Medicaid Services (CMS), Texas Medicaid & Healthcare Partnership (TMHP) and contracted payers. This position is responsible for submitting accurate and complete provider organizational and facilities providers enrollment applications, following up with payer credentialing departments and provider enrollment representatives to ensure providers are fully credentialed and loaded as participating with all applicable contracted health plans. The Credentialing Coordinator is accountable for maintaining and disseminating accurate plan participation status reports and billing information to all applicable PRHCN members to maximize collections in the revenue cycle management process.

Preferred Education:
Associates or Bachelor’s degree in healthcare management Required Skills:
Effective communication skills to interact professionally with clinical and financial health care colleagues; intermediate knowledge of Microsoft Office Preferred Skills:
2+ years managing a provider credentialing system

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.