Credentialing Coordinator

Credentialing Coordinator

DUTIES

• Application Management: Coordinate, prepare, submit, and monitor initial credentialing and recredentialing applications for all Clinical Reviewers, including the VHA Federal Personal Identity Verification (PIV) card process. Submit applications to the Credentialing Verification Organization (CVO), collaborate with IPRO’s Credentialing Coordinator, and provide ongoing follow-up to ensure timely completion of all credentialing requirements.
• Database Administration: Maintain and manage provider records within electronic databases and credentialing platforms. Generate queries, reports, and documentation while identifying opportunities to improve operational efficiency and data integrity.
• Compliance and Audit Management: Ensure provider files remain fully compliant with URAC standards, applicable state and federal regulations, contractual obligations, and organizational policies.
• Expiration and Renewal Oversight : Monitor and track the expiration of critical credentials and documentation, including state licenses, CPR certifications, malpractice and liability insurance, and other required credentials. Facilitate timely renewals to ensure uninterrupted compliance.
• Stakeholder Communication and Coordination: Serve as the primary point of contact among Clinical Reviewers, Medical Directors, and internal departments to resolve discrepancies, streamline onboarding activities, and support credentialing processes. Provide timely assistance regarding applications, documentation requirements, appointments, and PIV card access and facilitation.
• Meeting Management Coordinate and facilitate ongoing Credentialing Committee meetings involving internal stakeholders, external partners, clinical team members, and Medical Directors. Prepare meeting materials, document outcomes, and support follow-up activities as required.