Provider Credentialing Coordinator

The Provider Credentialing Coordinator will be responsible for designing and developing privilege forms for healthcare providers.

This role requires a strong understanding of healthcare regulations, provider credentialing, and privilege form development processes.

The ideal candidate will have excellent analytical skills, attention to detail, and the ability to collaborate effectively with various stakeholders.

Primary Responsibilities:

• Support the transition to new credentialing software, to ensure a smooth implementation and adoption across the facility

• Design, develop, and implement standardized privilege forms across multiple facilities for healthcare providers based on regulatory and organizational requirements.

• Provide analysis of current credentialing and privileging processes and forms.

• Provide data clean up in current system as needed.

• Actively support the transition to new software, including data migration, process optimization, and approval workflow(s) to enhance efficiency and accuracy.

• Support the standardization of credentialing and privileging policies and procedures across facilities

• Assist in reviewing, developing, and updating policies to ensure alignment with current legal, accreditation, and regulatory standards (e.g., TJC, NCQA, CMS, state boards)

• Collaborate with administrative, clinical, and external teams to gather requirements and ensure forms meet the needs of all stakeholders.

• Maintain and update existing privilege forms/sets to reflect changes in regulations and organizational policies.

• Conduct thorough testing and validation of privilege forms and processes to ensure accuracy and compliance.

• Maintain industry trends and best practices in provider credentialing and privilege forms.

• Provide training and support staff on the changes/updates and use of new standardized privilege forms.

• Performs other duties as assigned.

Qualifications (Must Have):

• Five years' experience in provider credentialing, privilege form development/management
• Credential Stream Experience
• Strong understanding of healthcare regulations and standards.
• Proficiency in provider credentialing and privileging software and tools.
• Excellent analytical and problem-solving skills.
• Strong communication and collaboration skills.
• Attention to detail and ability to manage multiple tasks/projects simultaneously.

Experience Level

Entry Level