Job Summary

The Credentialing Coordinator is responsible for coordinating provider onboarding activities to ensure newly hired clinicians are prepared for successful credentialing and enrollment. This role manages the collection and verification of provider information, establishes and maintains credentialing profiles, and ensures providers complete all required onboarding and enrollment documentation. The Credentialing Coordinator serves as the primary liaison between providers, Human Resources, Clinical Operations, and the Enrollment team to facilitate a seamless onboarding experience.

Essential Duties and Responsibilities

1. Coordinate onboarding activities for newly hired clinical providers to ensure all credentialing prerequisites are completed prior to enrollment submission.
2. Verify provider demographic and professional information, including legal name, licensure, certifications, education, and other required credentialing documentation.
3. Create and maintain National Provider Identifier (NPI) records for providers when applicable.
4. Establish, maintain, and update provider CAQH profiles, ensuring all required documentation remains complete and current.
5. Create provider profiles within MedTrainer and other credentialing systems. Updating CentralReach (CR) provider profiles and claim settings as necessary.
6. Collect required provider documentation, including licenses, board certifications, curriculum vitae, and other supporting documentation.
7. Guide providers through the completion of payer enrollment applications and required attestations, ensuring applications are complete and ready for submission.
8. Partner closely with the Credentialing Enrollment Specialist by providing completed enrollment packets and supporting documentation for payer submission.
9. Collaborate with Human Resources, Clinical Operations, and hiring managers to monitor onboarding progress and ensure providers meet targeted start dates.
10. Maintain organized and accurate provider credentialing records in accordance with organizational policies and regulatory requirements.
11. Monitor license expirations and other credentialing requirements during the onboarding process to ensure provider readiness.
12. Respond to provider questions regarding onboarding, credentialing requirements, and enrollment documentation.
13. Assist with maintaining credentialing workflows, onboarding checklists, standard operating procedures, and processing documentation.
14. Identify opportunities to improve onboarding efficiency and enhance the provider onboarding experience.

Qualifications:

• Exceptional organizational skills with strong attention to detail and a commitment to accuracy. 
• Ability to manage multiple onboarding, application, and credentialing-related tasks while meeting established deadlines. 
• Strong prioritization and time management skills, with the ability to balance competing priorities in a fast-paced environment. 
• Ability to coordinate provider onboarding activities and ensure timely collection of required documentation for credentialing and enrollment. 
• Proficient in Microsoft Office Suite and provider database, credentialing, and enrollment systems. 
• Experience maintaining accurate records, data integrity, and documentation within credentialing and onboarding platforms. 
• Strong verbal and written communication skills, with the ability to effectively interact with providers, internal departments, and external stakeholders. 
• Ability to follow established processes and identify opportunities to improve onboarding efficiency and provider experience. 
• Thorough understanding of confidentiality requirements and the ability to handle sensitive provider and organizational information with discretion. 
• Ability to work independently while collaborating effectively with Human Resources, Clinical Operations, Credentialing, and Compliance teams.

Education/Experience Requirements

• High school diploma or equivalent required.
• Associate's or Bachelor's degree in Healthcare Administration, Business Administration, or a related field preferred. 
• Minimum of one (1) year of experience in healthcare onboarding, credentialing, provider enrollment, medical office administration, or a related healthcare support role.

Physical Requirements

While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time. The team member is occasionally required to stand, walk, and use hands to operate a computer keyboard. The team member may occasionally lift and or move up to 25 pounds. Vision requirements include close vision, distance vision, depth perception and the ability to adjust focus.

Company Overview: 

Lighthouse Autism Center is the leading Applied Behavior Analysis (ABA) therapy provider in Indiana, Iowa, North Carolina, Nebraska, Michigan, and Illinois and expanding within those states and other states across the U.S. Since 2012, Lighthouse Autism Center has provided the highest quality, center-based ABA therapy to children with autism. At Lighthouse, children work on things like social skills, daily living skills, communication skills, and school-readiness skills. All children are overseen by Board Certified Behavior Analysts and programs are implemented by Registered Behavior Technicians. Lighthouse Autism Center also has full-time Speech-Language Pathologists on staff who provide co-treat and consultative services speech therapy services to children who attend the centers.