Credentialing Coordinator

Aquent has an exciting opportunity for a Credentialing Coordinator in Cumberland, RI!

This is a hybrid position. It will be required that you can work 1 day/week on-site. For this reason, we will only consider candidates who can comfortably commute to our client's location in Cumberland, RI.

In addition, to be considered for this role, you must:

• Be authorized to work in the United States
• Not require sponsorship of any kind for the duration of the assignment
• Be able to work on a W-2 basis. C2C or 1099 is not permitted for this role.

Imagine stepping into a role where your meticulous eye for detail and passion for operational excellence directly contribute to the smooth functioning of vital healthcare services! We're searching for an enthusiastic and highly organized professional to join a vibrant team dedicated to providing flawless administrative support for healthcare providers. This isn't just a job; it's an opportunity to be at the heart of ensuring compliance, efficiency, and high-quality care, making a profound impact on a large-scale healthcare environment.

**About the Company**

Our client is a leading organization at the forefront of the healthcare industry, dedicated to improving health outcomes and delivering accessible, high-quality care. With a commitment to innovation and patient well-being, they operate extensive healthcare service networks that touch countless lives. Joining their team means contributing to a mission-driven environment where operational efficiency and compliance are paramount to their success and impact on the community.

**About the Role**

Get ready to make a significant impact! As a Senior Coordinator in Provider Operations, you'll be the linchpin in managing the non-clinical facets of provider operations. This means ensuring every administrative process is not only robust and efficient but also perfectly compliant with industry standards. You'll thrive within a collaborative, cross-functional team, where your expertise in credentialing will directly empower healthcare providers to deliver exceptional patient care. Your work will uphold the highest standards of regulatory adherence and operational excellence, directly supporting the delivery of essential healthcare services and contributing to better health outcomes for all.

**Key Responsibilities**

* Support provider onboarding by ensuring all necessary collaborative practice agreements and prescriptive authority documents are fully executed, filed, and meticulously maintained.

* Manage initial credentialing and re-credentialing processes for a diverse range of medical professionals, including nurse practitioners, physician assistants, and physicians, ensuring timely completion and strict adherence to industry credentialing standards (e.g., Joint Commission, NCQA, URAC).

* Accurately record and maintain pertinent provider information within specialized database systems.

* Actively participate in and support various departmental projects as needed.

* Conduct thorough sanctions and compliance monitoring, promptly alerting relevant leadership to any undisclosed negative findings.

* Process malpractice insurance verification requests in strict accordance with internal policies.

* Maintain and update provider information platforms, communicating provider statuses to leadership and internal teams to meet critical timelines.

* Facilitate system access requests upon credentialing approvals and eligibility.

* Notify system analysts and leadership of any system interruptions, updates, or password changes impacting operations.

* Actively attend and engage in all team meetings, contributing to a collaborative environment.

* Model a positive and proactive attitude in all interactions with team members and stakeholders.

**What You Bring**

**Must-Have Qualifications:**

* 3+ years of experience in a fast-paced, complex administrative environment, with a strong emphasis on credentialing.

* Demonstrated in-depth understanding of initial credentialing and re-credentialing practices for medical professionals, including primary source verification methods, compliance monitoring, and expireables management.

* Prior experience working within a healthcare environment.

* Proven ability to adapt quickly to change in an energetic and evolving work setting.

* Exceptional communication skills, comfortable interacting effectively at all levels within an organization.

* Strong motivation to establish, maintain, and manage productive working relationships with colleagues, external vendors, and contracted physicians.

* Excellent problem-solving abilities, capable of assessing situations and making independent decisions when necessary.

* Experience in project management.

* Proficiency in Microsoft Excel.

* A verifiable High School Diploma or GED is required, along with an Associate's or Bachelor's degree.

**Nice-to-Have Qualifications:**

* NAMSS Certified Professional Credentialing Specialist (CPCS) certification.

* Experience with specialized credentialing software.

The target hiring compensation range for this role is $22.50 to $25.00 an hour. Compensation is based on several factors including, but not limited to education, relevant work experience, relevant certifications, and location.

**About Aquent Talent:**

Aquent Talent connects the best talent in marketing, creative, and design with the world's biggest brands.

Our eligible talent get access to amazing benefits like subsidized health, vision, and dental plans, paid sick leave, and retirement plans with a match. More information on our awesome benefits!

Aquent is an equal-opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. We're about creating an inclusive environment-one where different backgrounds, experiences, and perspectives are valued, and everyone can contribute, grow their careers, and thrive.