Credentialing Coordinator (29011)

Why work for Ampla Health? 29011

Ampla Health provides the individuals and communities we serve with high quality, comprehensive, community health care that is accessible to all and culturally and linguistically appropriate.

• Great Benefits including Medical, Dental, and Vision
• 4 weeks paid time off to start.
• 9 paid holidays
• 401k and profit sharing
• Full time, Monday to Friday
• Great work/home life balance

Serve as lead and primary resource for all staff, provide training and work direction to all staff, review and audit credentialing files for accuracy, monitor deadlines, identify process improvements, act as liaison between PAS Manager and staff. Individual will receive 10% increase for providing lead duties.

General Purpose

Under the supervision of the PAS Manager, the Provider Credentialing Coordinator manages the credentialing and enrollment process for providers, clinics, and pharmacies. This role ensures accurate and timely submission of applications, renewals, and documentation required for participation with insurance plans, third-party organizations, and special programs.

Key Responsibilities

• Process and maintain credentialing for providers, clinics, and pharmacies

• Coordinate and submit applications, renewals, and re-validations with insurance organizations and third-party entities

• Maintain provider files including licenses, identification numbers, and credentialing documentation

• Obtain and manage provider information such as NPI and CAQH profiles

• Track credentialing status, deadlines, and expirations using spreadsheets and internal systems

• Communicate with insurance companies and outside organizations to resolve credentialing issues

• Update and maintain provider rosters and credentialing records

• Assist the PAS Manager with credentialing projects and administrative support

Qualifications

• High school diploma required; some college preferred

• Minimum four (4) years of clerical or administrative experience

• Credentialing experience with providers, clinics, or pharmacies preferred

• Proficiency in Microsoft Excel and general office systems

• Strong organizational skills and ability to manage deadlines

Skills & Attributes

• Detail-oriented with strong problem-solving abilities

• Professional communication and interpersonal skills

• Ability to work independently and manage multiple credentialing processes