Credentialing Coordinator

Job Description

The Credentialing Coordinator provides foundational support for the credentialing, re-credentialing, and continuous monitoring processes within Privia’s medical group. This entry-level role focuses on administrative accuracy, ensuring that provider data is meticulously maintained and that initial inquiries are handled efficiently. By managing the early stages of the credentialing lifecycle, including Salesforce ticket triage and expirable tracking, this position ensures that our providers can focus on delivering high-quality care without administrative delays.

Primary Job Responsibilities: 

• Manage and resolve Tier 1 Salesforce cases by addressing basic provider inquiries and document requests.
• Monitor the renewal of expirables such as licenses, certifications, and COIs to ensure providers remain in good standing.
• Support the Primary Source Verification process for both initial applicants and re-credentialing cycles.
• Maintain accurate provider profiles within CAQH and internal credentialing databases.
• Track and record departmental statistics to help the team monitor workflow and productivity.
• Facilitate the flow of information between internal departments to resolve administrative issues.
• Prepare and coordinate basic reports under the direct supervision of the department manager.
• Adhere to all documented processes that align with NCQA, CMS, and state regulatory requirements.
• Handle all practitioner information with strict confidentiality.
• Other duties as assigned.

Qualifications

• At least 1 year of experience with credentialing PSV (Primary Source Verification) 
• Strong attention to detail and a high level of organizational skill
• Ability to communicate professionally and effectively with providers and internal staff
• Proficiency in basic problem solving and the ability to analyze administrative data
• Capability to work independently while remaining flexible in a fast-paced environment.
• Willingness to learn and interpret guidelines from various regulatory bodies
• Absolute commitment to maintaining the privacy of sensitive and confidential information

 The hourly range for this role is $22/hr to $25/hr in hourly base pay and exclusive of any bonuses or benefits (medical, dental, vision, life, and pet insurance, 401K, paid time off, and other wellness programs). This role is also eligible for an annual bonus targeted at 10%. The base pay offered will be determined based on relevant factors such as experience, education, and geographic location. 

Additional Information

All your information will be kept confidential according to EEO guidelines.

Technical Requirements (for remote workers only, not applicable for onsite/in office work):

In order to successfully work remotely, supporting our patients and providers, we require a minimum of 5 MBPS for Download Speed and 3 MBPS for the Upload Speed. This should be acquired prior to the start of your employment. The best measure of your internet speed is to use online speed tests like https://www.speedtest.net/. This gives you an update as to how fast data transfer is with your internet connection and if it meets the minimum speed requirements. Work with your internet provider if you have questions about your connection. Employees who regularly work from home offices are eligible for expense reimbursement to offset this cost.

Privia Health is committed to creating and fostering a work environment that allows and encourages you to bring your whole self to work. We understand that healthcare is local and we are better when our people are a reflection of the communities that we serve. Our goal is to encourage people to pursue all opportunities regardless of their age, color, national origin, physical or mental (dis)ability, race, religion, gender, sex, gender identity and/or expression, marital status, veteran status, or any other characteristic protected by federal, state or local law.