Credentialing Coordinator - Hybrid

Job Description

Job Description

Description:

Join Our Mission

Park DuValle Community Health Center is seeking a Credentialing Coordinator to serve as the primary liaison between our organization and an external credentialing partner.  

While the majority of the initial credentialing process will be managed by the third-party credentialing company, this role will monitor progress and ensure compliance with requirements, maintain provider records, and coordinate communication among stakeholders.

The Credentialing Coordinator will be responsible for monitoring provider enrollment status, tracking recredentialing deadlines, and utilizing our electronic medical record system to manage and update provider enrollment information.  This role will also work closely with our Revenue Cycle and Finance Team to investigate and resolve payer-related claim denials, identify enrollment issues impacting reimbursement, and assist with corrective actions to prevent gaps in reimbursement.

Key Responsibilities 

• Serve as the primary liaison between Park DuValle Community Health Center and the external credentialing vendor regarding credentialing and provider enrollment activities.
• Coordinate the collection of required documentation for provider payer enrollment, including Medicaid, Medicare, and other payer requirements.
• Track the status of provider payer enrollment, recredentialing, and revalidation applications.
• Maintain organized and accurate credentialing and payer enrollment files, including application status, supporting documentation, and payer correspondence.
• Communicate provider updates, including practice location changes, reassignment of benefits, and other required information, to the credentialing vendor.
• Follow up with the credentialing vendor and payers regarding outstanding documentation, application status, and processing delays.
• Update provider information within the electronic medical record (EMR) and other internal systems as needed.
• Collaborate with Human Resources to ensure required onboarding documentation is collected for provider credentialing and payer enrollment.
• Support resolution of credentialing denials, requests for additional information, and revalidation requirements.
• Work with Revenue Cycle and Finance teams to investigate payer-related claim denials and enrollment issues that may impact reimbursement.
• Monitor credentialing timelines and help ensure required documentation, renewals, and revalidations are completed on schedule.
• Prepare routine reports and maintain accurate records related to provider credentialing and enrollment activities.
• Perform other related duties as assigned.

• Associate's degree in healthcare administration, Business Administration, or a related field.
• Two years of experience in healthcare administration, provider enrollment, credentialing support, or healthcare billing; or an equivalent combination of education and experience.
• Experience working with healthcare providers, credentialing vendors, or payer organizations.
• Familiarity with provider credentialing and/or enrollment processes.
• Exposure to CAQH and healthcare payer systems.
• Strong organizational skills with the ability to manage multiple priorities and deadlines.
• Excellent written and verbal communication skills.
• High attention to detail and accuracy in documentation and data entry.
• Proficiency with Microsoft Office Suite, including Excel, Word, and Outlook.
• Ability to quickly learn credentialing software, payer portals, and electronic medical record (EMR) systems.
• Strong interpersonal skills and the ability to collaborate effectively with providers, vendors, and cross-functional teams.
• Customer service mindset with strong problem-solving abilities.

Benefits and Perks

We offer a competitive and comprehensive benefits package designed to support your health, financial well-being, and professional growth.

• Hybrid work schedule.
• Medical, dental, vision, and life insurance.
• Voluntary benefits, including short-term disability.
• 403(b) retirement plan with employer match up to 5%.
• Paid Time Off (PTO).
• Eleven paid holidays.
• Predictable work schedule.
• Opportunity to serve diverse and underserved communities.

Why Join PDCHC?

At Park DuValle Community Health Center, you'll be part of a mission-driven organization dedicated to improving the health and well-being of our community while working alongside professionals who value teamwork, integrity, and excellence.

Apply Today

If you're an organized, dependable professional with experience in healthcare credentialing, provider enrollment, or healthcare administration, we'd love to hear from you.

Equal Opportunity Employer: Park DuValle Community Health Center is committed to creating an inclusive workplace and provides equal employment opportunities to all employees and applicants in accordance with applicable federal, state, and local laws.