Role Overview:

The Credentialing Coordinator is responsible for processing and completing the credentialing and re-credentialing functions of all providers in accordance with NCQA, state, and federal requirements.

Work Arrangement: Remote   

Responsibilities:

• Validates completeness of provider applications prior to processing 
• Conducts primary source verification for all credentialing and re-credentialing applications
• Monitors the progress and completion of all site visits by the provider network team to ensure completion within the established timeframe
• Accurately enters all critical data elements of provider applications into the Credentialing system  
• Responds to phone inquiries received into the Credentialing phone queue from internal and external clients 
• Completes projects as assigned

Education/ Experience:

• High School/GED required with 4 years of credentialing experience
• Bachelor’s Degree with 1 year of credentialing experience or related experience preferred
• 1 to 4 years of prior provider credentialing experience based on a combination of education and experience

Skills & Abilities:

• Intermediate knowledge of PC applications, including Microsoft Office
• Strong verbal and written communication skills
• Strong organizational skills required 
• Ability to perform in a metrics-driven environment
   

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.