Credentialing Analyst / Coordinator

Job Title: Credentialing Analyst / Coordinator Pay Rate: $25.00 / hour Job Type: Full-Time

Job Summary The Credentialing Analyst / Coordinator is responsible for data analysis as well as the timely and compliant initial credentialing and re-credentialing of Nurse Practitioners (NPs), Physician Assistants (PAs), Behavioral Health Providers, and Physicians (MDs/DOs). This role plays a critical part in monitoring expired credentials, running compliance reports, and managing database updates in strict accordance with Joint Commission Accreditation, NCQA, and URAC credentialing standards.

Key Responsibilities

• Credentialing & Re-Credentialing: Process timely and accurate initial credentialing and re-credentialing applications for all provider types (NPs, PAs, MDs, Behavioral Health) in accordance with program guidelines.
• Compliance & Monitoring: Conduct sanction checks and ongoing compliance monitoring. Alert leadership immediately regarding any undisclosed negative findings.
• Expirables Management: Monitor expired licensure, board certifications, and malpractice insurance verification; issue weekly reporting to leadership.
• Access & System Control: Manage system/EHR (Epic) access for providers with out-of-compliance licensure or certifications. Submit system access requests upon approval/eligibility.
• Data & File Maintenance: Daily maintenance of provider credentialing grids, provider files, and SharePoint sites. Communicate provider status across internal teams to ensure operational timelines are met.
• Cross-Functional Support: Support payer enrollment teams to resolve claims issues and assist with Payer Audits (Joint Commission and NCQA requirements).
• Database & Workflow Updates: Monitor provider and clinic change/termination reports, execute name changes, distribute incoming mail, and notify system leadership of state agency/system interruptions or password updates.
• Quality & Collaboration: Work alongside team coordinators to meet productivity benchmarks, identify process improvements, and maintain high accuracy across all deliverable workflows.

Qualifications & Requirements

Required:

• Experience: Minimum of 3 years of healthcare industry experience specifically focused on provider credentialing and re-credentialing.
• Technical Skills:
• Proficient with MDStaff credentialing software.
• Proficient with Microsoft Office Suite (specifically MS Excel and MS Word).
• Demonstrated proficiency in quantitative analysis.
• Standards & Compliance: Strong understanding of Joint Commission Accreditation, NCQA, and URAC credentialing standards, primary source verification methods, and expirable management.
• Core Competencies: Strong critical thinking skills, excellent verbal and written communication, exceptional organizational abilities, and a track record of effective stakeholder collaboration.

Preferred:

• NAMSS Certified Professional Credentialing Specialist (CPCS) certification.

Pay Details: $25.00 per hour

Benefit offerings available for our associates include medical, dental, vision, life insurance, short-term disability, additional voluntary benefits, EAP program, commuter benefits and a 401K plan. Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave or any other paid leave required by Federal, State, or local law, as well as Holiday pay where applicable.

Equal Opportunity Employer/Veterans/Disabled

Military connected talent encouraged to apply

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The Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:

• The California Fair Chance Act
• Los Angeles City Fair Chance Ordinance
• Los Angeles County Fair Chance Ordinance for Employers
• San Francisco Fair Chance Ordinance

Massachusetts Candidates Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability.