ജോലി വിവരണം

Role overview

This is a United States-based credentialing coordination role posted for a partner organization that handles the application review and next steps. The position focuses on keeping provider credentialing and recredentialing accurate, timely, and compliant within a large healthcare setting. You will work with internal stakeholders and external providers to gather, check, and process important documentation, while helping ensure network participation remains in good standing.

The job is suited to someone who is highly organized, careful with details, comfortable with administrative workflows, and able to support compliance-focused healthcare operations. Precision, communication, and follow-through are essential because the work directly affects provider readiness and regulatory adherence.

Core duties

Manage the full credentialing and recredentialing workflow for healthcare providers, including tracking applications and entering information into credentialing systems.
Complete primary source checks for provider credentials in line with NCQA and CMS requirements.
Keep an eye on expiring documents, sanctions, and other compliance items so credentialing remains current.
Examine applications and follow up for any missing or incomplete details.
Build and maintain credentialing files that are ready for internal review and audit purposes.
Work with internal teams and outside providers to answer credentialing questions and share updates.
Stay informed about changing NCQA and CMS credentialing standards.
Assist with special assignments and operational initiatives as directed by leadership.

Requirements

High school diploma or equivalent, plus at least 1 year of administrative experience; alternatively, an associate, bachelor’s, or master’s degree may be accepted in place of experience.
Familiarity with NCQA and CMS credentialing rules is preferred.
Strong planning and prioritization abilities with the capacity to juggle several tasks at once.
High accuracy and careful attention to detail when handling data and documents.
Comfort using Microsoft Office, especially Excel, along with general computer systems.
Clear written and spoken communication skills in a professional setting.
Ability to perform well in a busy, deadline-oriented environment.
Willingness to handle repetitive administrative work while maintaining focus and accuracy.
Flexibility to adjust to shifting workloads and changing operational needs.

Benefits and work environment

Full-time schedule with 40 hours per week.
Stable healthcare environment with an established organizational structure.
Chance to contribute to meaningful healthcare operations.
Exposure to credentialing practices aligned with NCQA and CMS standards.
Opportunity to grow professionally in healthcare administration and compliance.
Collaborative, structured team setting.
Access to standard employee benefits such as health, dental, vision, and retirement options where available.
Paid time off and recognized holidays, subject to eligibility.

Application and data-processing notes

The application process is handled by a partner employer, and the final review, interviews, assessments, and hiring decisions are managed by their internal team. The recruiting process may use AI tools to help review applications, evaluate responses, and identify inconsistencies or verification signals, but human review remains part of the process. By applying, candidates agree that personal data may be processed for candidacy evaluation and shared with the hiring employer in line with applicable data protection laws, including rights related to access, correction, deletion, and objection.

Credentialing Coordinator