Credentialing Coordinator III
3901 Lone Tree Way Antioch, CA 94509 US
Job Description
This role requires extensive hands-on experience with medical staff credentialing processes, including verification of licensure, board certification, malpractice coverage, and professional references, as well as familiarity with Echo credentialing software.
Essential Duties and Responsibilities
Administer and oversee all aspects of credentialing, recredentialing, and privileging for physicians, allied health professionals, and contracted providers.
Perform primary source verification (PSV) of licensure, board certifications, malpractice claims history, DEA/CDS registrations, and other required credentials.
Maintain, audit, and update provider data in the Echo credentialing system, ensuring accuracy and timeliness of records.
Support Medical Staff leadership and committees by preparing and distributing credentialing reports and ensuring all required documentation is complete before review.
Ensure compliance with regulatory agencies (e.g., Joint Commission, CMS, NCQA) and company’s internal policies.
Liaise with external health plans, auditors, and regulatory bodies during credentialing audits and reviews.
Collaborate closely with physician leaders and department managers to resolve credentialing discrepancies or delays.
Participate in continuous process improvement initiatives to streamline credentialing workflows and reduce turnaround time.
Maintain confidentiality of all provider and organizational information in accordance with HIPAA and company policy.
Required Qualifications
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- Minimum of 3 years of recent, hands-on experience in medical staff credentialing or provider enrollment within a hospital or health system setting.
- Echo Credentialing Software proficiency is required.
- Demonstrated experience using Microsoft Teams and Microsoft Office Suite (Word, Excel, Outlook)
- Deep understanding of credentialing standards, bylaws, and accreditation requirements (Joint Commission, CMS, NCQA).
- Working knowledge of medical staff office operations and governance processes.
- Exceptional attention to detail and data accuracy.
- Strong organizational, analytical, and communication skills.
- Ability to work independently under tight deadlines in a fast-paced environment
- Professional demeanor and ability to interact effectively with physicians and administrative leaders.
- Certified Provider Credentialing Specialist (CPCS) certification through NAMSS preferred.
- Experience supporting medical staff committees or working directly with physician leadership in a credentialing office environment.
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