Healthcare Credentialing Coordinator – Part-Time – Remote

Overview We are seeking a detail-oriented individual to join our team as a Healthcare Credentialing Coordinator. Your expertise will be essential in providing exceptional service to our clients. Come join us and make a meaningful impact in the healthcare industry! Responsibilities • Confirm and verify provider credentials, including licenses, board certifications, education, training, work history, and references. • Assist healthcare providers with credentialing and re-credentialing applications for Wisconsin Medicaid, Medicare, and commercial payers, ensuring all required documents are accurate, complete, and submitted on time. • Coordinate the credentialing process for physical therapists, physical therapist assistants (PTAs), occupational therapists, certified occupational therapy assistants (COTAs), speech-language pathologists (SLPs), and other allied health professionals. • Prepare and submit credentialing applications to relevant organizations, insurance companies, and government agencies, maintaining accuracy and compliance with payer and regulatory requirements. • Conduct primary source verification by contacting educational institutions, licensing boards, professional organizations, and previous employers, and maintain thorough documentation of all verification activities. • Maintain up-to-date and accurate provider records in credentialing systems such as CAQH Pro View, ensuring attestations, malpractice coverage, licensure, and other required information are current. • Create and maintain CAQH profiles for new providers, update practice locations in Pro View, and keep the credentialing tracking report current for internal reference. • Monitor and track expiration dates for licenses, certifications, and insurance policies, proactively notifying providers of upcoming renewals and assisting with the renewal process. • Manage the re-credentialing process to ensure timely renewals and continuous compliance with all payers, state, and federal requirements. • Manage Medicare Part B credentialing for providers through the CMS PECOS system, including completing and submitting CMS-855I applications, linking providers to group practices with CMS-855R, uploading required documentation, and coordinating with Medicare Administrative Contractors (MACs) to obtain PTANs. • Stay current with Medicare enrollment regulations, platform changes, and payer-specific credentialing requirements, and adjust processes accordingly. • Respond promptly to insurance company and payer documentation requests and serve as the primary liaison between providers, insurance companies, regulatory agencies, and internal departments. • Communicate effectively and professionally with all stakeholders to resolve credentialing-related issues or discrepancies in a timely manner. • Participate in quality assurance activities to ensure the accuracy and integrity of the credentialing process. Identify areas for improvement and implement necessary changes to enhance efficiency. • Attend weekly update meetings. • Any and all duties as assigned. Qualifications High school diploma, general education degree (GED). • Previous experience in medical credentialing or related field. • Knowledge of credentialing processes, regulations, and standards. • Familiarity with medical terminology and the healthcare industry. • Attention to detail and organizational skills. • Excellent communication and interpersonal skills. • Proficient in using credentialing software and databases. • Ability to work independently and handle multiple tasks simultaneously. • Adherence to ethical standards and confidentiality guidelines. Associate or Bachelor’s degree. Why work for us? At Symbria our employees act like owners — because we are owners! As one of the few 100% employee‑owned healthcare providers, our focus remains on delivering best‑in‑class services within our Pharmacy, Rehabilitation and Well‑Being operations, which allows our clients to improve the lives and well‑being of their patients and residents. Our teams utilize insights and analytics to drive better health outcomes for our partnered post‑acute and senior living communities while providing them with flexible service options. Symbria’s Core Values drive the way we…