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 also 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 will 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. Essential Functions Coordinate and process initial credentialing and re‑credentialing. Maintain an up‑to‑date physician database of all applications, demographics, medical licenses, drug enforcement records, professional liability insurance, training, board certification, etc. Review credentialing applications for completeness, accuracy, and compliance with regulatory and accreditation standards. Perform primary source verification of provider licenses, certifications, education, training, work history, malpractice coverage, and sanctions. Maintain and update provider credentialing files, databases, and tracking systems. Job Requirements Required High School Diploma / GED Three (3) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment Preferred Bachelor’s degree Certified Provider Credentialing Specialist (CPCS) Five (5) years of experience Where You’ll Work Hello humankindness Located conveniently in the heart of Phoenix, Arizona, St. Joseph's Hospital and Medical Center is a 571‑bed, not‑for‑profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved. We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high‑risk obstetrics, neuro‑rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought‑after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s. U.S. News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children’s Hospital. St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. For the health of our community ... we are proud to be a tobacco‑free campus. #J-18808-Ljbffr CommonSpirit Health