Credentialing & Privileging Coordinator- Hybrid (1 day/month)

Legacy Community Health - Houston, TX

Part-time,Full-time - Mid Level

Remote - Houston, TX

11-50 employees

Ambulatory Health Care Services

About the position

The Credentialing & Privileging Coordinator is responsible for the accurate collection and validation of provider data necessary for privileging healthcare providers at Legacy Community Health. This role involves overseeing the onboarding and payor enrollment functions to ensure compliance with Medicare and other regulatory requirements, while serving as a liaison between the organization and external entities.

Responsibilities

• Obtain and verify credentialing information from multiple state, federal, and accreditation sources according to requirements and standards.
• Ensure compliance with accrediting and regulatory agencies regarding credentialing functions, including application management and primary source verification.
• Conduct onboarding document requests and primary verification sources.
• Serve as the primary contact for providers during the onboarding and privileging process, facilitating review activities.
• Prepare and maintain credentialing files and reports, including managing credentialing software and provider rosters.
• Coordinate, collect, review, and compile privileging information for approval by the governing board.
• Prepare for and coordinate credentialing audits in compliance with managed care contracts.
• Maintain the privileging share drive and credentialing software to ensure records are current and accurate.

Requirements

• Associate's degree or equivalent experience required.
• At least five years of experience as a credentialing coordinator or specialist.
• Demonstrated knowledge of credentialing and privileging guidelines and standards.
• Strong detail-oriented and organizational skills, with the ability to work under pressure.
• Ability to maintain strict confidentiality of information.

Benefits

• 403(b) matching
• AD&D insurance
• Paid holidays
• Disability insurance
• Dental insurance
• Paid time off
• Employee assistance program
• Vision insurance
• Gym membership
• Bereavement leave
• Life insurance