This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Credentialing Coordinator based in the United States.
This role plays a key part in ensuring the accuracy, compliance, and timeliness of provider credentialing and recredentialing processes within a large healthcare environment. You will support the onboarding and ongoing verification of healthcare providers, helping maintain the integrity of network participation and payer relationships. The position involves close coordination with internal teams and external providers to collect, validate, and process critical documentation. You will also monitor expiring credentials, track applications, and ensure compliance with NCQA and CMS standards. This is a detail-driven, administrative role where precision, organization, and communication directly impact provider readiness and regulatory compliance. You will contribute to a fast-paced healthcare operations environment where quality and accuracy are essential to patient care delivery.
Accountabilities:
In this role, you will manage end-to-end credentialing and recredentialing processes for healthcare providers, ensuring all data and documentation meet regulatory and organizational standards. You will support compliance efforts while maintaining accurate records and facilitating communication across stakeholders.
- Coordinate provider credentialing and recredentialing workflows, including application tracking and data entry into credentialing systems
- Perform primary source verification of provider credentials in compliance with NCQA and CMS standards
- Monitor expiring documents, sanctions, and compliance requirements to ensure continuous credentialing validity
- Review credentialing applications and request missing or incomplete information as needed
- Prepare and maintain credentialing files for review and audit readiness
- Communicate with internal teams and external providers to resolve credentialing-related inquiries and updates
- Maintain working knowledge of evolving NCQA and CMS credentialing standards
- Support special projects and operational initiatives as assigned by supervision
Requirements
This role requires strong administrative skills, attention to detail, and the ability to manage structured processes in a regulated healthcare environment. The ideal candidate is organized, communicative, and comfortable working with data, documentation, and deadlines.
- High school diploma or equivalent with 1+ year of administrative experience, or associate/bachelor’s/master’s degree in lieu of experience
- Knowledge of NCQA and CMS credentialing regulations (preferred)
- Strong organizational and prioritization skills with the ability to manage multiple tasks
- High attention to detail and strong accuracy in data entry and documentation
- Proficiency in Microsoft Office, including Excel, and general computer systems
- Strong written and verbal communication skills in a professional environment
- Ability to work effectively in a fast-paced, deadline-driven setting
- Comfortable handling repetitive administrative tasks with sustained focus and accuracy
- Ability to adapt to changing workloads and operational priorities
Benefits
- Competitive full-time employment structure (40 hours per week)
- Comprehensive healthcare system environment with strong organizational stability
- Opportunity to support mission-driven healthcare operations
- Exposure to NCQA and CMS credentialing standards and processes
- Professional development in healthcare administration and compliance
- Collaborative and structured work environment
- Standard employee benefits package (health, dental, vision, and retirement options where applicable)
- Paid time off and recognized holidays (based on eligibility).