Astrana Health
Credentialing Coordinator – Astrana Health
Location:
19500 HWY 249, Suite 570 Houston, TX 77070
Compensation:
$18.00 – $21.00 / hour
Department:
Ops – Credentialing
Job Overview We are currently seeking a highly motivated Credentialing Coordinator. This role will report to the Supervisor – Credentialing and enable us to continue to scale in the healthcare industry. The Credentialing Coordinator fulfills all activities required for successful completion of initial and re‑credentialing applications. This is a hybrid/remote role where the expectation is to work both in office and at home on a weekly basis (dependent on the employee’s location).
What You’ll Do
Review and process healthcare providers’ credentialing applications to ensure compliance with health plan participation requirements.
Verify providers’ professional qualifications, including education, licensure, and certifications.
Maintain and update credentialing records for all providers within the health plan network.
Submit credentialing applications to health plans for review and approval.
Monitor re‑credentialing timelines, ensuring timely renewal of certifications, licenses, and memberships.
Ensure compliance with federal, state, and health plan‑specific regulations and policies.
Collect required documentation from providers, including diplomas, licenses, certifications, and malpractice insurance.
Address and resolve discrepancies or issues encountered during the credentialing process.
Protect the confidentiality of sensitive provider and patient information.
Assist with audits and respond to health plan inquiries regarding credentialing status.
Collaborate with internal departments to resolve credentialing‑related issues and maintain accurate data.
Qualifications
High School Diploma.
Proven experience in credentialing within a health plan or managed care setting.
Strong knowledge of credentialing procedures and regulatory standards for health plans.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
Excellent organizational skills and attention to detail.
Ability to maintain confidentiality and manage sensitive information.
Effective written and verbal communication skills.
Preferred
Certification from a credentialing organization (e.g., National Association of Medical Staff Services, NAMSS).
Experience using credentialing software or databases.
Familiarity with medical terminology and healthcare provider networks.
You have a bachelor’s degree in Business, Communications, Healthcare, or a similar field.
Environmental Job Requirements and Working Conditions
Hybrid work structure: onsite 2 days a week, with the position reporting to our Houston office at 19500 HWY 249 Suite 570 Houston, TX 77070.
Compensation range: $18.00 – 21.00 per hour. This salary range represents our national target range for this role.
Equal Employment Opportunity Astrana Health is proud to be an Equal Employment Opportunity and Aff…ere… employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
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19500 HWY 249, Suite 570 Houston, TX 77070
Compensation:
$18.00 – $21.00 / hour
Department:
Ops – Credentialing
Job Overview We are currently seeking a highly motivated Credentialing Coordinator. This role will report to the Supervisor – Credentialing and enable us to continue to scale in the healthcare industry. The Credentialing Coordinator fulfills all activities required for successful completion of initial and re‑credentialing applications. This is a hybrid/remote role where the expectation is to work both in office and at home on a weekly basis (dependent on the employee’s location).
What You’ll Do
Review and process healthcare providers’ credentialing applications to ensure compliance with health plan participation requirements.
Verify providers’ professional qualifications, including education, licensure, and certifications.
Maintain and update credentialing records for all providers within the health plan network.
Submit credentialing applications to health plans for review and approval.
Monitor re‑credentialing timelines, ensuring timely renewal of certifications, licenses, and memberships.
Ensure compliance with federal, state, and health plan‑specific regulations and policies.
Collect required documentation from providers, including diplomas, licenses, certifications, and malpractice insurance.
Address and resolve discrepancies or issues encountered during the credentialing process.
Protect the confidentiality of sensitive provider and patient information.
Assist with audits and respond to health plan inquiries regarding credentialing status.
Collaborate with internal departments to resolve credentialing‑related issues and maintain accurate data.
Qualifications
High School Diploma.
Proven experience in credentialing within a health plan or managed care setting.
Strong knowledge of credentialing procedures and regulatory standards for health plans.
Proficiency in Microsoft Office Suite (Word, Excel, Outlook).
Excellent organizational skills and attention to detail.
Ability to maintain confidentiality and manage sensitive information.
Effective written and verbal communication skills.
Preferred
Certification from a credentialing organization (e.g., National Association of Medical Staff Services, NAMSS).
Experience using credentialing software or databases.
Familiarity with medical terminology and healthcare provider networks.
You have a bachelor’s degree in Business, Communications, Healthcare, or a similar field.
Environmental Job Requirements and Working Conditions
Hybrid work structure: onsite 2 days a week, with the position reporting to our Houston office at 19500 HWY 249 Suite 570 Houston, TX 77070.
Compensation range: $18.00 – 21.00 per hour. This salary range represents our national target range for this role.
Equal Employment Opportunity Astrana Health is proud to be an Equal Employment Opportunity and Aff…ere… employer. We do not discriminate based on race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other legally protected characteristics. All employment is decided on the basis of qualifications, merit, and business need. If you require assistance in applying for open positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation.
Additional Information The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.
#J-18808-Ljbffr