{"id":1678631,"url":"https://alion.io/job/page-communitycare-credentialing-privileging-coordinator","title":"Credentialing & Privileging Coordinator","company":{"id":2135431,"name":"CommunityCare","domain":"communitycaretx.org","url":"https://alion.io/company/communitycaretx","size_band":"201-500","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"iCIMS","truth_index":null},"role":"Administrative","role_family":"Administrative","seniority":"junior","employment_type":null,"work_mode":"remote","remote_scope":"stated_countries","remote_scope_basis":"board_field","remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Austin, United States"],"countries":["US"],"hiring_countries":["US"],"hiring_countries_total":1,"salary":null,"salary_estimate":{"min_usd":41000,"max_usd":71000,"period":"year","method":"role_seniority_country_remote_cell","sample_n":308},"experience_years_min":2,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[{"name":"HIPAA","optional":false}],"status":"live","first_seen_at":"2026-10-02T09:14:20Z","employer_posted_date":"2026-10-02","last_verified_at":"2026-10-20T08:42:30Z","board_verified":true,"closed_at":null,"days_open":18,"trust":{"level":"ok","repost_count":null,"flags":[],"days_open":18},"description":"Overview\nUnder the direction of the Credentialing Manager, the Credentialing Coordinator is responsible for coordinating all aspects of the credentialing and/or recredentialing process as well as changes in privileges/specialty or demographic information for health care professionals practicing within CommUnityCare health centers. This position ensures health care professionals are appropriately credentialed and privileged, including ongoing maintenance and verification of current information on file and within the credentialing database, and other duties required to maintain compliance with regulatory and accreditation agencies and CommUnityCare credentialing policies and procedures.\nResponsibilities\nEssential Duties (at least 5 that are non-negotiable duties and are absolutely pertinent to successfully completing the job without accommodations):\nReviews, screens, and completes initial credentialing and/or recredentialing, and additional privilege request applications for completeness, accuracy, and compliance with federal, state, local, and CommUnityCare regulations, standards, policies, and guidelines.\nPerform and collect primary source verification (PSV) of all credentialing elements and validates the information to ensure accuracy.\nData entry of new applications in the credentialing database.\nCommunicates clearly with providers, their credentialing representative, and leadership as needed to provide timely updates and responses on day-to-day credentialing and privileging issues as they arise.\nAnalyzes, identifies, resolves discrepancies, time gaps, and other issues that could impact ability to credential healthcare practitioners.\nReport issues in a timely manner to Credentialing Manager for decision making in accordance with credentialing and privileging policy and federal state, local, and government and health plans standards.\nProvide consistent and timely follow-up on all outstanding credentialing/re-credentialing files.\nProcess provider demographic changes ensuring appropriate documentation has been submitted with the changes, update credentialing database and notify health plans of changes.\nPrepare and scan credentialing/re-credentialing files and other credentialing documentation into electronic folder.\nMaintain knowledge of current requirements for credentialing providers.\nEnsure all tasks duties comply with all regulatory and accreditation standards including The Joint Commission, the National Committee Quality Assurance (NCQA) guidelines, and CommUnityCare Standard Operating Procedures and CommUnityCare Policies and Procedures.\nResponsible for monitoring and managing credentials/recredentialing requirement to ensure the collection of all required renewals are on file within their required time frame.\nResponsible for the timely entry, processing, and tracking of credentialing files.\nOther Job Responsibilities\nEnsure all actions, job performance, personal conduct and communications always represent CommUnityCare in a highly professional manner.\nUphold and ensure compliance, confidentiality and adhere to all HIPAA guidelines, and maintain a strict level of confidentiality for all company policies and procedures, departmental, and healthcare provider information as well as the overall mission and values of the organization.\nEnsure that all work is done in a timely and accurate manner.\nWorks within established credentialing timeframes and notifies manager as to status and barriers preventing work being done in a timely and accurate manner.\nMaintain strong working relationships with providers, health plan staff, and other credentialing verification offices.\nDevelop and maintain favorable internal relationships, partnerships with co-workers.\nResponsible for the monthly ongoing monitoring of licenses and sanctions.\nAudit disciplinary reports, OIG reports, and other reports as required and initiate the formal complaint procedure, when applicable.\nParticipates in staff meetings and recommends new approaches, policies and procedures to effect continual improvement in efficiency of the department and services performed.\nRespond to emails timely and effectively.\nProvide support to physicians, physician office staff, and company departments as necessary.\nAssist with annual Health Plan delegated credentialing audits.\nCross train within department to support credentialing operations (back-up support for credentialing files, vacation/PTO).\nParticipate in various educational/training as required.\nPerform other job-related duties as assigned.\nKnowledge/Skills/Abilities:\nArticulates knowledge and understanding of organizational policies, procedures, and systems.\nAbility to function effectively and work under pressure in a demanding and fast paced environment.\nAbility to manage change, delays, or unexpected events appropriately, and demonstrate sense of urgency and strong time management awareness.\nStrong organizational, problem solving, and critical thinking skills, and to proactively prioritizes needs and effectively manages resources.\nExcellent interpersonal and customer service skills.\nInformation research skills.\nAbility to communicate effectively both orally and in writing.\nAbility to use independent judgment and to manage and impart confidential information.\nAbility to function effectively in a remote work environment.\nAbility to work in both individual or group environment and multitask as needed.\nDemonstrate proficiency in Microsoft Word, Excel and Access.\nKnowledge of CAQH (Council for Affordable Quality Healthcare) database and application process.\nKnowledge of Medicare and Medicaid provider enrollment systems.\nQualifications\nMINIMUM EDUCATION: High School Diploma MINIMUM EXPERIENCE: 2 years of experience in practitioner credentialing with a working knowledge of federal and state regulatory agencies and accrediting bodies (CMS, TJC, NCQA, etc.) REQUIRED CERTIFICATIONS/LICENSURE: Certified Professional Credentialing Specialist (CPCS) within first 3 years of employment if not already certified upon 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