Credentialing Operations Coordinator
Employment Information
Job Description
Credentialing Coordinator supporting compliance and provider operations for a virtual obesity care provider. Managing licensing and credentialing across all states to ensure compliance and efficiency.
Responsibilities:
- Track all provider licensing and credentialing operations through Medallion, including new license applications, renewals, re-credentialing and ongoing file maintenance.
- Complete, submit and follow up on credentialing requests and applications on a regular schedule that will result in faster turnaround times.
- Resolve any deficiencies with credentialing or licensing in compliance with regulatory requirements.
- Set up and manage provider information in multiple platforms.
- Support the execution, renewal and tracking of Collaborative Practice Agreements (CPAs) for Nurse Practitioners in applicable states, coordinating signatures and submissions in partnership with Supervising Physicians.
- Verify NPIs, DEA numbers, board certifications and other provider enrollment data to maintain integrity across Medallion, CAQH and internal Vida systems.
- Ensure strict HIPAA compliance and confidentiality in all data handling.
- Collaborate with Compliance to maintain NCQA-compliant credentialing files and assist with internal audits.
- Serve as a subject matter resource for licensing, credentialing and CPA workflows internally and externally.
- Resolve deficiencies, discrepancies and expired documentation within established timelines.
- Communicate professionally and proactively with providers, boards and internal teams to ensure a smooth credentialing and licensing experience.
- Other duties as assigned.
Requirements:
- Associates degree at a minimum.
- CPCS certification preferred.
- 1-2 years of experience in provider licensing, credentialing or enrollment, preferably in telehealth.
- Experience with licensing platforms- i.e IMLC, eNLC, state board websites.
- Proficiency with Medallion and CAQH.
- Knowledge of state licensing and collaborative practice agreement requirements for Nurse Practitioners.
- Decisiveness and attention to detail: you can catch even the smallest errors.
- Resourceful: you usually have the answer, but when you don’t, you know where to find it.
- Continuous improvement mindset: you are always looking for ways to go from “good” to “great” in order to support team efficiency.
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