Credentialing Coordinator Medical

3 weeks ago

Antioch CA, United States Kavaliro Full time

Credentialing Coordinator III Pay Rate : $65.00
Assignment Type: Temporary assignment expected to last approximately 3 months, with potential for extension based on department needs
Work Schedule: Full-time, On-site
Department : Medical Staff Services

Our client is seeking a Scheduler for a contract opportunity for a healthcare organization. The Credentialing Coordinator III is responsible for performing advanced credentialing and recredentialing functions in alignment with standards, federal and state regulatory requirements, and health plan credentialing criteria. This position plays a key role in maintaining the integrity and accuracy of provider data, ensuring compliance, and supporting the timely onboarding and privileging of medical staff and allied health professionals.

This role requires extensive hands-on experience with medical staff credentialing processes, including verification of licensure, board certification, malpractice coverage, and professional references, as well as familiarity with Echo credentialing software.

Administer and oversee all aspects of credentialing, recredentialing, and privileging for physicians, allied health professionals, and contracted providers.
Perform primary source verification (PSV) of licensure, board certifications, malpractice claims history, DEA/CDS registrations, and other required credentials.
Maintain, audit, and update provider data in the Echo credentialing system, ensuring accuracy and timeliness of records.
Support Medical Staff leadership and committees by preparing and distributing credentialing reports and ensuring all required documentation is complete before review.
Ensure compliance with regulatory agencies (e.g., Joint Commission, CMS, NCQA) and Sutter Healths internal policies.
Liaise with external health plans, auditors, and regulatory bodies during credentialing audits and reviews.
Collaborate closely with physician leaders and department managers to resolve credentialing discrepancies or delays.
Participate in continuous process improvement initiatives to streamline credentialing workflows and reduce turnaround time.
Maintain confidentiality of all provider and organizational information in accordance with HIPAA and company policy.

Minimum of 3 years of recent, hands-on experience in medical staff credentialing or provider enrollment within a hospital or health system setting.
Echo Credentialing Software proficiency is required.
Demonstrated experience using Microsoft Teams and Microsoft Office Suite (Word, Excel, Outlook)
Deep understanding of credentialing standards, bylaws, and accreditation requirements (Joint Commission, CMS, NCQA).
Working knowledge of medical staff office operations and governance processes.
Exceptional attention to detail and data accuracy.
Professional demeanor and ability to interact effectively with physicians and administrative leaders.
Certified Provider Credentialing Specialist (CPCS) certification through NAMSS preferred.
Experience supporting medical staff committees or working directly with physician leadership in a credentialing office environment.

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