Remote Credentialing Coordinator

4 Corner Resources is hiring a Remote Credentialing Coordinator to support one of our enterprise-level, non-profit managed care clients. This position will support credentialing operations by reviewing provider information, maintaining accurate credentialing records, verifying documentation, and ensuring credentialing activities are completed in accordance with regulatory and organizational requirements.
 
Required Skills & Qualifications

• High school diploma or GED.
• 2+ years of credentialing experience or related healthcare administrative experience.
• Experience supporting provider credentialing processes and maintaining credentialing documentation.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.
• Strong time management and ability to manage multiple priorities.
• Must be authorized to work in the U.S. without sponsorship.
• Must reside in one of the following states:
  AL, FL, GA, IN, IA, KS, LA, MS, NC, NE, NV, NH, NJ, NY, OK, SC, SD, TN, TX, VA, WV, WY

• Experience with CAQH, NPPES, PECOS, or similar credentialing systems.
• Experience verifying licenses, certifications, provider information, and supporting documentation.
• Bachelor’s degree preferred.
• Proficiency with Microsoft Office, including Excel, Word, and PowerPoint.
• Experience with Adobe, Microsoft Access, SAS, or SQL is a plus.
• Strong critical thinking, problem-solving, and analytical skills.

• Support provider credentialing activities in accordance with regulatory requirements and company policies.
• Review and verify provider applications, licenses, certifications, and supporting documentation.
• Maintain accurate and complete credentialing files and records.
• Track credentialing activities, outstanding documentation, and required follow-up.
• Identify and resolve credentialing discrepancies and escalate issues as needed.
• Prepare credentialing reports and documentation for internal review.
• Collaborate with internal departments, providers, and third-party vendors to ensure timely completion of credentialing activities.
• Support audits and compliance reviews related to credentialing.
• Assist with provider data and directory updates to ensure accuracy.
• Identify opportunities to improve credentialing processes and workflows.
• Perform additional credentialing and administrative duties as assigned.

 


4CR3