Credentialing Coordinator

2 weeks ago


Newtown Square, Pennsylvania, United States Center for Orthopedic and Research Excel Full time
Position Overview

The Credentialing Specialist plays a crucial role in ensuring that healthcare providers meet the necessary qualifications and standards. This position is essential for maintaining compliance and supporting the operational efficiency of our organization.

Key Benefits:

  • Competitive salary ranging from $18 to $22 per hour.
  • Comprehensive health and welfare benefits package.
  • Health Savings Account (HSA) options with qualifying high-deductible health plans, including company contributions.
  • 401(k) retirement plan with company matching after six months of employment, applicable to part-time employees as well.
  • Access to a 24/7 Employee Assistance Program for personal and professional support.
  • Opportunities for employee appreciation events and wellness initiatives.

Required Qualifications:

  • A minimum of two years of experience in credentialing.
  • High school diploma or GED; equivalent experience is preferred.
  • Effective communication skills with physicians, providers, licensing bodies, insurance companies, and the general public.
  • Adept at building strong working relationships with both internal teams and external partners.
  • Familiarity with insurance billing processes and hospital credentialing is advantageous.

Core Responsibilities:

  • Review and finalize applications for hospitals and payors on behalf of healthcare providers.
  • Complete verification forms and letters for external facilities.
  • Maintain updated records for billing insurance grids, provider insurance grids, and individual physician spreadsheets reflecting current insurance changes.
  • Monitor and manage physician licensure, certifications, and continuing medical education (CME) credits.
  • Organize and maintain credentialing files for practitioners.
  • Ensure electronic files for practitioners are current with all applications and licensure.
  • Oversee renewal applications for hospitals and insurance providers.
  • Understand and adhere to the Employee Handbook and established policies and procedures.
  • Follow established guidelines and instructions to perform job functions effectively.
  • Assist the Credentialing Supervisor with various responsibilities as needed.


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