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Credentialing Specialist

Salary undisclosed

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Job Summary

The NP Credentialing Coordinator is responsible for providing administrative and operational support in credentialing and re-credentialing Nurse Practitioners (NPs) to ensure compliance with regulatory requirements and practice guidelines.

Key Responsibilities

  • Credentialing Coordination:
  • Assist in gathering, reviewing, and verifying credential documentation, such as licenses, certifications, and insurance.
  • Maintain up-to-date provider information in the credentialing database.
  • Track credentialing status and follow up with Credentialing Committee to ensure timely approvals.
  • Documentation and Compliance:
  • Ensure all credentialing files are compliant with federal, state, and organizational regulations as directed.
  • Monitor the expiration dates of licenses, certifications, and other required documentation, sending timely reminders for renewals.
  • Prepare and submit re-credentialing applications as needed.
  • Data Management and Reporting:
  • Maintain accurate, organized, and confidential credentialing files.
  • Generate reports on credentialing activities, status, and compliance metrics.
  • Continuously update internal databases to reflect current provider status.
  • Provider Onboarding Support:
  • Support the onboarding process by ensuring credentialing steps are completed before start dates.

Act as a liaison between providers and various credentialing bodies, answering questions and resolving issues.

  • Relationship Management:
  • Build and maintain positive relationships with Nurse Practitioners, payers, and credentialing bodies.
  • Coordinate with internal departments such as Human Resources, Compliance, and Legal to streamline credentialing processes.

Qualifications

Education:

  • High school diploma or equivalent required; an associate degree or relevant certification in healthcare administration, business, or a related field is preferred.

Experience

  • 1-2 years of experience in a credentialing, compliance, or healthcare administration role.
  • Familiarity with practice credentialing requirements and healthcare regulations is a plus.

Skills

  • Strong organizational skills and attention to detail.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and experience with credentialing software or databases.
  • Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
  • Customer service-oriented approach with a focus on building professional relationships.
Job Summary

The NP Credentialing Coordinator is responsible for providing administrative and operational support in credentialing and re-credentialing Nurse Practitioners (NPs) to ensure compliance with regulatory requirements and practice guidelines.

Key Responsibilities

  • Credentialing Coordination:
  • Assist in gathering, reviewing, and verifying credential documentation, such as licenses, certifications, and insurance.
  • Maintain up-to-date provider information in the credentialing database.
  • Track credentialing status and follow up with Credentialing Committee to ensure timely approvals.
  • Documentation and Compliance:
  • Ensure all credentialing files are compliant with federal, state, and organizational regulations as directed.
  • Monitor the expiration dates of licenses, certifications, and other required documentation, sending timely reminders for renewals.
  • Prepare and submit re-credentialing applications as needed.
  • Data Management and Reporting:
  • Maintain accurate, organized, and confidential credentialing files.
  • Generate reports on credentialing activities, status, and compliance metrics.
  • Continuously update internal databases to reflect current provider status.
  • Provider Onboarding Support:
  • Support the onboarding process by ensuring credentialing steps are completed before start dates.

Act as a liaison between providers and various credentialing bodies, answering questions and resolving issues.

  • Relationship Management:
  • Build and maintain positive relationships with Nurse Practitioners, payers, and credentialing bodies.
  • Coordinate with internal departments such as Human Resources, Compliance, and Legal to streamline credentialing processes.

Qualifications

Education:

  • High school diploma or equivalent required; an associate degree or relevant certification in healthcare administration, business, or a related field is preferred.

Experience

  • 1-2 years of experience in a credentialing, compliance, or healthcare administration role.
  • Familiarity with practice credentialing requirements and healthcare regulations is a plus.

Skills

  • Strong organizational skills and attention to detail.
  • Excellent written and verbal communication skills.
  • Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and experience with credentialing software or databases.
  • Ability to manage multiple tasks and meet deadlines in a fast-paced environment.
  • Customer service-oriented approach with a focus on building professional relationships.