Credentialing Coordinator

Job Locations US-MA-Acton
ID
2025-3685
Category
Accounting/Finance
Type
Regular Full Time
Weekly Hours
40
Days per Week
5

Overview

Reporting to the Manager of Payor Relations and Credentialing, the Credentials Coordinator is responsible for credentialing APDerm® providers which includes assisting the providers with the completion of credentialing paperwork, hospital medical staff applications, provider enrollment forms and applications for malpractice insurance. This position will work closely with various departments including Human Resources, Operations, Recruiting and Revenue Cycle.

 

Responsibilities

  • Updates and maintains provider credentialing tracking in Modio.
  • Maintain CAQH website for all providers.
  • Provider Licensing and Certificates
    • Provides support to providers by assisting in state license, DEA and controlled substance applications.
  • Hospital Credentialing:
    • Provide requested information to hospitals in a timely manner including collection and distribution of all required documents and forms
  • Provide insurance companies with any updates on provider information PRN.
  • Update PECOS for providers and revalidate accounts
  • Regularly communicates with providers to provide updates on the status of his/her credentialing applications.
  • Participates in other duties and responsibilities as assigned.

Qualifications

 

  • Understanding of CAQH
  • Bachelor’s degree in Healthcare Administration, Business or related field preferred
  • Demonstrate a professional and adaptable demeanor with internal and external clients, including administrators, physicians, peers, and support staff;
  • Exhibit a high energy level, and demonstrate the ability to work as a valuable contributor to the team, with flexibility in work habits to schedule and meet the needs of the Department;
  • The ability to multi-task, plan and prioritize a large volume of detail-oriented work in accordance with changing deadlines;
  • Advanced computer skills including, but not limited to, Microsoft Outlook, Microsoft Word, and Excel;
  • Strong analytic and problem solving and project management abilities;
  • Must be a highly motivated candidate with the ability to work independently and in a highly fluid environment

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