Top 3 Credentialing coordinator Jobs in Upland, Ca

Credentialing Coordinator
Golden Gate Health —Fontana, CA
- $24 - $26 an hour
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Mid-level
- Health insurance
- Dental insurance
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Medical Staff Coordinator - Medical Staff Administration - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
USC —Los Angeles, CA
Pref Associate's degree Degree in related field OR. Pref Bachelor's degree Degree in related field. Participates in facility/credentialing preparation for site…
$34.32 - $56.19 an hour
Medical Staff Coordinator - Medical Staff Administration - Full Time 8 Hour Days (Non-Exempt) (Non-Union)
Keck Medical Center of USC —Los Angeles, CA
Pref Associate's degree Degree in related field OR. Pref Bachelor's degree Degree in related field. Participates in facility/credentialing preparation for site…
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Credentialing Coordinator
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Performs other administrative tasks at the request of management as related to credentialing and board certification documentation.
Credentialing Coordinator, Lead
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Performs other administrative tasks at the request of management as related to credentialing and board certification documentation.

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Credentialing Coordinator

Golden Gate Health
Fontana, CA

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Job Details

Full-time
$24 - $26 an hour

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance

Qualifications

Microsoft Excel
Microsoft Outlook
Managed care organization experience
Health insurance policy knowledge
Provider enrollment for medical credentialing
CMS
Databases
Administrative experience
CMS regulatory compliance
Data management
Medicare regulations
Healthcare privacy protection
Health information regulatory compliance
Medicaid regulations
Health information management
Regulatory compliance analysis
Medical terminology
Healthcare software applications

Full Job Description

Job Overview

We are seeking a highly organized and detail-oriented Credentialing Coordinator to join our healthcare team. In this vital role, you will manage the credentialing and re-credentialing processes for healthcare providers, ensuring compliance with all relevant regulations and standards. Your expertise will help maintain the integrity of provider information, facilitate smooth medical payer enrollment, and support the organization’s commitment to healthcare compliance and accreditation standards. This position offers an exciting opportunity to contribute to a dynamic healthcare environment where accuracy, efficiency, and regulatory knowledge are paramount.

Duties

Manage the end-to-end credentialing process for healthcare providers, including initial applications, re-credentialing, and ongoing verification
Review medical credentialing applications thoroughly for completeness and accuracy, ensuring adherence to NCQA standards and accreditation requirements such as JCAHO
Maintain and update provider databases using healthcare software applications and medical credentialing software to ensure data integrity
Coordinate medical payer enrollment activities with insurance companies and government agencies like CMS, ensuring timely submission of credentialing documents
Monitor compliance with health regulation policies, state healthcare regulations, and CMS regulatory requirements to uphold healthcare accreditation standards
Handle confidential information with utmost discretion, adhering to healthcare compliance protocols and privacy laws
Collaborate with internal teams on contract management related to provider agreements and credentialing processes
Prepare detailed reports on credentialing status, provider eligibility, and regulatory compliance for internal review

Requirements

Proven experience in managed care environments with a strong understanding of health insurance policies and payer enrollment procedures
Administrative experience within healthcare settings, including familiarity with medical terminology and healthcare software applications
Proficiency in Microsoft Office Suite (Word, Excel, Outlook) for documentation and communication purposes
Experience using medical credentialing software platforms and databases for managing provider information effectively
Knowledge of Centers for Medicare and Medicaid Services (CMS) regulations and requirements for provider credentialing and compliance
Understanding of health regulation policies such as NCQA standards, JCAHO accreditation standards, and state healthcare regulations
Strong attention to detail when reviewing medical credentialing applications and supporting documentation
Excellent organizational skills with experience managing multiple tasks simultaneously in a fast-paced environment
Ability to handle confidential information securely while maintaining compliance with healthcare privacy laws
Contract management experience in healthcare is preferred but not required

Join us in this rewarding role where your expertise will directly impact the quality of care delivered by our organization. We value proactive professionals who thrive on precision, regulatory knowledge, and delivering exceptional service in a complex healthcare landscape.

Pay: $24.00 - $26.00 per hour

Benefits:

401(k)
Dental insurance
Health insurance
Paid time off
Vision insurance

Work Location: In person

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credentialing coordinator jobs in upland, ca

Credentialing Coordinator

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