Credentialing Coordinator

Location: Charlotte, NC
Company: Diligent Billing and Management, LLC (DBM)
Department: Admin
Reports to: QA/Credentialing Manager
Employment Type: Full-Time
FLSA Classification: Non-Exempt

Primary Responsibilities

The Credentialing Coordinator is responsible for the full process of physicians’ credentialing, which includes state licenses, hospitals, and payers through organizing, maintaining, and verifying all aspects of the credentialing process.

Essential Functions

• Maintain accurate records, data, contact names, and expiration dates on state licensure, hospital privileges, Continuing Medical Education (CME), and other necessary credentialing documentation for clients and physicians.
   
• Responsible for the full cycle of initial credentialing for new physicians within a timely manner, which includes hospital privileges, payer networks, state licensure, malpractice insurance, etc.
   
• Responsible for recredentialing for current physicians within given due dates, which includes hospital privileges, payer networks, state licensure, etc.
   
• Gather Continuing Medical Education (CME) documentation from each physician to provide accurate totals for license renewals and MOC participation.
   
• Retain company documents electronically by maintaining accurate records in credentialing software and network folders.
   
• Convey a positive, service-oriented attitude when interacting with all employees and external business contacts.
   
• Use discretion on any information shared with external sources.
   
• Ensure that providers stay compliant through OIG/SAM database checks, state licensure checks, and payer-required webinars and attestations.
   
• Provide other assistance as designated by the Manager to support overall goals of the department and company.
   
• Assist with departmental compliance tasks as needed.
   

Educational / Training Requirements

High School Diploma or equivalent (Required)  

Experience Requirement

1–2 years Medical or related field with thorough understanding of physician credentialing and payer enrollment (Required)

Knowledge in healthcare compliance, including privacy and security regulations, confidentiality laws, access, and release information (Plus)

Skills and Abilities

• Good organizational and project management ability.
   
• Proficient in Microsoft Office Suite, with a focus in Excel and Outlook.
   
• Must have good command of the English language.
   
• Must be self-sufficient and able to work independently in a remote environment.
   
• Must have strong verbal and written communication skills.
   
• Must be willing to help others and be a team player.
   

Work Environment

The physical demands and work environment described here are representative of those that must be met by the employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Long periods of sitting at a workstation
   
• Frequent periods of standing and/or walking
   
• Frequent repetitive motions
   
• Occasionally able to lift or move up to 10 lbs.
   
• The noise level in the work environment is usually moderate
   

Physical Demands

• Long periods of sitting at a workstation
   
• Frequent standing and/or walking
   
• Frequent repetitive motions
   
• Occasionally able to lift or move up to 10 lbs.
   
• Moderate noise level in the work environment  

DBM is an equal-opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.