Credentialing Coordinator

Where You’ll Work Hello humankindness Located conveniently in the heart of Phoenix, Arizona,St. Joseph's Hospital and Medical Center is a 571-bed, not-for-profit hospital that provides a wide range of health, social and support services. Founded in 1895 by the Sisters of Mercy, St. Joseph's was the first hospital in the Phoenix area. More than 125 years later, St. Joseph's remains dedicated to its mission of caring for the poor and underserved. We are extremely proud to be a nationally recognized center for quality quaternary care, medical education and research. St. Joseph's includes the internationally renowned Barrow Neurological Institute, Norton Thoracic Institute, Cancer Center at St. Joseph's, Ivy Brain Tumor Center, and St. Joseph's Level I Trauma Center (which is verified by the American College of Surgeons). The hospital is also a respected center for high-risk obstetrics, neuro-rehabilitation, orthopedics, and other medical services. St. Joseph’s is considered a sought-after destination hospital for treating the most complex cases from throughout the world. Every day, approximately 20 percent of the hospital’s patients have traveled from outside of Arizona and the United States to seek treatment at St. Joseph’s. U.S News & World Report routinely ranks St. Joseph's among the top hospitals in the United States for neurology and neurosurgery. In addition, St. Joseph's boasts the Creighton University School of Medicine at St. Joseph's, and a strategic alliance with Phoenix Children's Hospital. St. Joseph's is consistently named an outstanding place to work and one of Arizona's healthiest employers. Come grow your career with one of Arizona's Most Admired Companies. Look for us on Facebookand follow us on Twitter. For the health of our community ... we are proud to be a tobacco-free campus. Job Summary and Responsibilities The Credentials Coordinator is responsible for managing all aspects of provider credentialing and re-credentialing. This includes ensuring compliance with The Joint Commission, NCQA, CMS, and all applicable state, federal, and organizational requirements. The coordinator works closely with providers, medical staff offices, and internal departments to facilitate these processes. Essential Functions: Coordinate and process initial credentialing, recredentialing. Maintains up-to-date physician database of all applications, demographics, medical licenses, drug enforcement, professional liability insurance, training, board certification etc. Review credentialing applications for completeness, accuracy, and compliance with regulatory and accreditation standards. Perform primary source verification of provider licenses, certifications, education, training, work history, malpractice coverage, and sanctions. Review credentialing applications for completeness, accuracy, and compliance with regulatory and accreditation standards. Maintain and update provider credentialing files, databases, and tracking systems. Monitor expiration dates for licenses, certifications, malpractice insurance, and other required credentials; initiate timely follow-up for renewals. Communicate with providers, medical staff offices, and internal departments to obtain required documentation and resolve discrepancies. Ensure compliance with NCQA, CMS, state, federal, and organizational credentialing requirements. Track credentialing timelines and ensure all applications are completed within established turnaround standards. Support internal and external audits, accreditation reviews, and regulatory reporting activities. Research and resolve credentialing issues, discrepancies, or incomplete information in a timely manner. Generate reports and provide status updates related to credentialing activities and provider file compliance. Maintain confidentiality of provider and organizational information in accordance with HIPAA and company policies. Assist with process improvement initiatives to enhance credentialing workflow efficiency and accuracy. Job Requirements REQUIRED High School Diploma / GED Three (3) years experience in a Health Care Plan Credentialing/Provider Relations and/or auditing setting, or Health Care Enrollment PREFERRED Bachelors degree Certified Provider Credentialing Specialist (CPCS) Five (5) years of experience