HR Credentialing Coordinator

JOB SUMMARY

The Credentialing Coordinator is responsible for coordinating provider credentialing, recredentialing for medical, behavioral health and dental staff.

JOB DUTIES

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required:

• Process initial credentialing and recredentialing applications for providers.
• Maintain and update provider records, licenses, certifications, DEA registrations, malpractice insurance, and continuing education documentation.
• Track credentialing deadlines, expirations, and revalidation requirements.
• Verify provider credentials through primary source verification.
• Maintain compliance with FQHC standards and regulatory guidelines.
• Work closely with billing, revenue cycle, HR, compliance, and clinical leadership teams.
• Prepare reports on credentialing status and provider enrollment activity.
• Other duties as assigned.

QUALIFICATIONS

• High school diploma required; Associate's or Bachelor's degree preferred.
• 3+ years of healthcare credentialing experience required.
• Knowledge of FQHC operations.
• Strong attention to detail and organizational skills.
• Proficiency with Microsoft Excel, Word, and credentialing software.
• Ability to manage multiple deadlines independently.

SMART GOALS (OUTCOMES)

• Achieve and maintain a 100% compliance rate for provider licenses, DEA registrations, malpractice insurance, and certifications by conducting monthly audits and updating records before expiration dates throughout the year.
• Ensure 100% of recredentialing applications are submitted at least 90 days before due dates during the next calendar year.
• Maintain complete and audit ready credentialing files for 100% of providers, with no major deficiencies identified during internal or external audits over the next year.
• Credential and enroll all newly hired providers within established onboarding timelines, without enrollment-related delays.

PHYSICAL REQUIREMENTS

The physical demands described are representative of those that must be met by an employee to successfully perform. The employee frequently is required to stand, walk, and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds.

WORKING CONDITIONS

(The unavoidable, externally imposed conditions under which the work must be performed, and which create hardship for the incumbent including the frequency and duration of occurrence of physical demands, environmental conditions, demands on one’s senses, and mental demands.) None known.

EMPLOYMENT CONDITIONS

This job description is to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee’s ability to perform the duties as described. This job description is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned as deemed appropriate commensurate to the position. This document does not represent a contract of employment, and Friend Health - HRDI reserves the right to change this job description and /or assign tasks deemed as needed.

Friend Health – HRDI is an equal opportunity employer. We consider all applicants for employment without regard to race, religion, color, age, sex, national origin, citizenship, ancestry, marital or parental status, sexual orientation including gender identity, gender expression, military discharge status, physical or mental disability, or any other status or characteristic protected by law. In addition, Friend Health – HRDI provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local laws (including during the application or hiring process). Friend Health - HRDI supports the Pay Transparency Law as an equal opportunity employer.

Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.