Connections Health Solutions

Credentialing Coordinator

• Manage the end-to-end credentialing, re-credentialing, and payer enrollment process for behavioral health providers, behavioral health support staff, and facilities
• Manage new provider onboarding from HR/Talent Acquisition notification through completion of the Medallion profile
• Enter and maintain provider information including NPI, licensure, practice locations, and payer information
• Request required documentation including CAQH, PECOS, state licenses, DEA registrations, board certifications, diplomas, and other credentials; track completion
• Communicate with physicians and providers by phone, text, and email to explain requirements, resolve outstanding items, and answer questions
• Research and interpret state licensing, supervision, collaborative agreement, and scope-of-practice requirements
• Complete primary source verifications including NPI, NPDB, Medicare/Medicaid opt-out, state licensure, DEA, OIG, and SAM checks
• Escalate adverse findings through the credentialing committee review process
• Coordinate malpractice policy additions and upload insurance documentation to the credentialing platform and CAQH
• Manage commercial and government payer enrollment applications, effective dates, payer IDs, and recredentialing dates
• Maintain and re-attest provider CAQH profiles
• Support cross-state licensure and payer enrollment for telehealth providers
• Facilitate state and program-specific registrations, Medicaid portal enrollment, domain transfers, surrogacy requests, and Medicare enrollment through CMS/PECOS
• Manage NPI acquisition and state Medicaid enrollment for behavioral health support staff; distribute compliance reports
• Manage facility-level enrollment and maintenance in state Medicaid systems
• Process provider and BHS staff terminations and notify applicable payers
• Monitor OIG/SAM and NPDB databases, license renewals, board certifications, and recredentialing cycles
• Complete credentialing documentation under delegated credentialing requirements
• Partner with HR, Talent Acquisition, Medical Leadership, and operational leadership
• Participate in quarterly Credentialing Committee meetings and prepare regular status reporting
• Support standardized credentialing workflows, reference guides, process documentation, and SOPs
• Perform other duties and responsibilities as assigned

Explore Credentialing Coordinator, FT, Days at Connections Health Solutions. Review requirements and application details.

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Credentialing Coordinator, FT, Days