Credentialing Coordinator Job Description Template
The Credentialing Coordinator is responsible for the organization and maintenance of all provider credentials, privileging and site accreditation. The credentialing coordinator will work with various medical staff offices, departments, insurance companies and state licensing boards to ensure that all providers meet the requirements for hospital privileges and insurance paneling. The credentialing coordinator will also maintain up-to-date knowledge of changes in state licensure, Medicare/Medicaid regulations and other third party payer requirements.
Credentialing Coordinator Job Responsibilities
- Maintain and update provider credentials in a timely manner
- Verify provider credentials against primary sources
- Monitor and track credentialing status of providers
- Notify providers of credentialing status and next steps
- Assist providers with the credentialing process
- Serve as a liaison between providers and payors during the credentialing process
- Keep abreast of updates to payor credentialing requirements
- Other duties as assigned
Objectives
- To coordinate and oversee the credentialing process for new and existing employees.
- To ensure that all credentials are up to date and meet the requirements of the organization.
- To maintain accurate records of employee credentials and keep track of changes or updates.
- To liaise with different departments within the organization to ensure timely completion of the credentialing process.
- To provide support and guidance to employees during the credentialing process.
Credentialing Coordinator Job Skills & Qualifications Needed
- There are no specific educational requirements for the role of credentialing coordinator, however most coordinators have at least a bachelor's degree. Many also have certification from the National Association of Credentialing Services (NACES). The skills needed for the role include strong communication and organizational skills, as well as attention to detail.