Credentialing Coordinator
Aya Healthcare
Credentialing Analyst
Southern New Hampshire Health has been a cornerstone of the region since 1893, delivering high-quality, compassionate care close to home. Anchored by Southern New Hampshire Medical Center, a 188-bed, DNV-accredited hospital in downtown Nashua with a Level III-N trauma center, Level II Special Care Nursery, and Magnet designation for nursing excellence, we offer a full spectrum of services from primary care to advanced diagnostics and specialized treatments. Our medical staff includes over 500 providers from Foundation Medical Partners, and local practices. Foundation Medical Partners, our multi-specialty group, spans 70+ practices across southern New Hampshire and northern Massachusetts, providing coordinated, patient-centered care to thousands each year.
The credentialing analyst position assists the manager in overseeing the credentials and enrollments for over 340 providers in Foundation Medical Partners and also assists the credentialing analyst at Southern NH Medical Center in onboarding new providers. This person also oversees the onboarding of new providers who will be providing services to Foundation Medical Partners. This position is vital to new providers starting on their anticipated start date to meet the clinical needs of the practice they are hired into. This allows the practice to maintain (if we are replacing a provider) or grow their patient access (if we are hiring an additional provider). The other vital component of this position is to get the provider enrolled with the payers our organization contracts with as soon as possible. This ensures our organization will be paid for the services they provide to our patients. With the robust activity of recruitment and the challenges of payer enrollments this position is essential in meeting our organization's goal of growing primary care, cardiovascular services, cancer care, digestive health, orthopedics, neurosciences and emergency/urgent care while also growing our financial strength.
Initiates the Medical/Allied Health Professional Staff appointment application process
Outlines licensing and DEA requirements for NH and MA
Verifies education contact information
Initiates/Updates Professional Liability Insurance
Prepares insurance applications for provider to complete and sign
Completes/updates provider credentialing data in the universal Provider Data Source CAQH
Initiates/maintains enrollment with insurance plans
Follows up with insurance plan of provider effective date
Updates insurance plans with provider/practice change of information
Assists the Business Office with resolving claim processing issues due to provider enrollment
Data entry in the credentialing software system of all provider license, DEA and Board Certification expirations
Runs reports to notify provider and manager of expiring credentials
Follows up on all expiring credentials to ensure compliance with provider employment agreement
Researches Federal, State and Local guidelines for licensing and maintaining credentials
Has exceptional attention to detail
Has excellent verbal and written communication skills
Has the ability to prioritize tasks to meet strict deadlines
Experienced: You possess at least two (2) years of healthcare office experience specifically within a credentialing role (experience in a medical staff services department is preferred).
Educated & Certified: You hold a High School diploma or equivalent. A Certified Provider Credentialing Specialist (CPCS) designation is a strong plus.
Tech-Savvy: You are proficient with Microsoft Office Suite, particularly Word, Excel, and Outlook, with the ability to maintain complex databases.
Detail-Oriented & Organized: You have exceptional time-management skills, a keen eye for detail, and the ability to multitask effectively under tight deadlines.
Discreet: You possess a demonstrated ability to properly handle and protect highly confidential, sensitive information.
Health, dental, prescription, and vision coverage for full-time & part-time employees
Short-term, long-term disability, life & pet insurance
Tuition reimbursement & Nursing Student Loan Paydown Program
403(b) Retirement savings plans
Continuous earned time accrual & more!
$23 - $25 per hour
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