Astrana Health, Inc.
Credentialing Coordinator
Department:
Ops - Credentialing
Employment Type:
Full Time
Location:
19500 HWY 249, Suite 570 Houston, TX 77070
Reporting To:
Anna Vesel
Compensation:
$18.00 - $21.00 / hour
Description 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. Key responsibilities include Credentialing Committee preparation and scheduling, responding to health plan credentialing audits, and successful integration of credentialing files for newly acquired entities. 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
You're great for this role if:
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 Bachelors degree in Business, Communications, Healthcare, or similar field
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work onsite 2 days a week. This position will report to our Houston office at 19500 Hwy 249 Suite 570 Houston, TX 77070.
The total pay range for this role is: $18.00 - 21.00 per hour. This salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and affirmative action employer. We do not discriminate based upon 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 applicable 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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Ops - Credentialing
Employment Type:
Full Time
Location:
19500 HWY 249, Suite 570 Houston, TX 77070
Reporting To:
Anna Vesel
Compensation:
$18.00 - $21.00 / hour
Description 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. Key responsibilities include Credentialing Committee preparation and scheduling, responding to health plan credentialing audits, and successful integration of credentialing files for newly acquired entities. 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
You're great for this role if:
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 Bachelors degree in Business, Communications, Healthcare, or similar field
Environmental Job Requirements and Working Conditions
Our organization follows a hybrid work structure where the expectation is to work onsite 2 days a week. This position will report to our Houston office at 19500 Hwy 249 Suite 570 Houston, TX 77070.
The total pay range for this role is: $18.00 - 21.00 per hour. This salary range represents our national target range for this role.
Astrana Health is proud to be an Equal Employment Opportunity and affirmative action employer. We do not discriminate based upon 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 applicable 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