Role: Credentials Coordinator
Duration: 1+ Year Contract
Pay Rate: $22.00–$26.00/hour W2
Location: Detroit, MI
Schedule: Hybrid, 2 days on-site
Position Overview
The Credentials Coordinator will support the credentialing and recredentialing process for healthcare practitioners, provider organizations, and facilities. This role is responsible for reviewing applications, verifying provider information, obtaining required primary-source documentation, maintaining accurate credentialing records, and ensuring files meet applicable regulatory and accreditation requirements.
Key Responsibilities
Process practitioner, provider organization, and facility applications for credentialing and recredentialing.
Request, collect, review, and verify primary-source documentation and other required credentialing information.
Maintain accurate and current provider information within the credentialing system of record.
Review credentialing files for completeness, identify potential issues, categorize cases appropriately, and communicate findings to the Medical Director and Enterprise Credentialing Committee.
Research and resolve questions regarding credentialing files, documentation, and application status.
Provide credentialing status updates to physicians, provider offices, group administrators, Provider Services, Customer Service, and Network Development teams.
Participate in Credentials Committee meetings, internal meetings, and credentialing audits when assigned.
Support special projects and assist with the development or maintenance of credentialing job aids and processes.
Education & Experience
Associate degree preferred.
2–5 years of experience in credentialing, provider enrollment, provider contracting, a medical practice, hospital business office, or a closely related healthcare environment.
Working knowledge of credentialing requirements and standards associated with NCQA, DIFS, MDHHS, CMS, and applicable state and federal regulations.
Experience working with CAQH is required.
Skills & Qualifications
Strong organizational skills with excellent attention to detail.
Ability to manage multiple credentialing files, deadlines, and priorities simultaneously.
Strong written and verbal communication skills.
Ability to work independently while also collaborating effectively within a team environment.
Strong interpersonal skills with the ability to communicate professionally with providers, internal departments, and external customers.
Intermediate proficiency with Microsoft Word, Excel, Access, PowerPoint, and internet-based systems.
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