Credentialing Coordinator

Advocate Aurora Health

Credentialing Coordinator overseeing support for credentialing activities in a healthcare system. Managing practitioner applications, reappointments, and external customer communication with best practices.

Posted 6/27/2026full-timeRemote • Alabama, Alaska, Arizona, Florida, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Mississippi, Missouri, Montana, Nevada, New Hampshire, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin, Wyoming • 🇺🇸 United StatesMid-LevelSenior💰 $24 - $36 per hourWebsite

About the role

Key responsibilities & impact

Coordinates credentials verification and analysis activities to support appointment, reappointment and other credentialing activities to the practitioners of the medical staff of all Advocate Aurora Health hospitals, surgical clinics and health network, and external customers.
Evaluates requests for applications and obtains authorization as needed.
Determines appropriate action to accept or deny application requests.
Initiates application process.
Processes applications, reappointments and other credentialing events to the Medical Staff/Network, assessing practitioner information to determine the presence of potentially adverse information and determines further action required.
Responsible for quality control on the content and completeness of finalized practitioner credentials files for our clinical staff in Wisconsin and Illinois.
Coordinates biennial review, ensuring each practitioner seeking reappointment is evaluated according to requirements by external accreditation and regulatory standards.
Documents all work performed for credentialing events in database as part of the communication with internal customers.
Communicates the progress, completion and findings of ongoing applications to leadership, and as appropriate to other customers.
Identifies evolving issues of concern and takes appropriate action.
Maintains credentialing database according to department policies and procedures and regulatory guidelines.
Provides an electronic historical record of credentialing events within the organization.
Responsible for investigation and documentation of practitioner credentials, utilizing specialized knowledge to obtain verification of all aspects of a practitioner's background, training and past practice.
Understands credentialing requirements of both The Joint Commission and NCQA, CMS and other governmental requirements, and performs in accordance with these standards.
Generates and maintains accurate documentation that may be reviewed and judged for acceptability by state and federal licensing agencies, external customers and may be called into a court of law to justify decision-making by Aurora entities.
Manages external audits for delegated credentialing contracts, prepares and reviews files, transmits to delegate, demonstrates adherence to NCQA standards through individual credentialing records.
Evaluates privilege requests to ensure that required supporting documentation named in privilege criteria is included.
Deals with customer questions and complaints by Aurora Health Care caregivers, physicians, allied health practitioners and external agencies.

Requirements

What you’ll need

Credentialing Specialist, Certified Provider (CPCS) issued by the National Association Medical Staff Services (NAMSS) is preferred but not required
Typically requires 3 years of experience in physician credentialing, medical education, a hospital environment and/or health insurance
Excellent communication, organizational and problem-solving skills
Proficiency in the use of Microsoft Office (Excel, Access, PowerPoint and Word) and credentialing software
Ability to sit for extended periods
Ability to use a computer, enter data, and write for extended periods
Ability to organize and professionally manage demanding workload
Demonstrated team player and self-motivated
Preferred knowledge of accrediting and regulatory agencies as related to the Medical Staff, including (but not limited to) Joint Commission, DNV, HFAP, CMS, OSHA, NCQA, and State and Federal Law and other standards and regulations, and hospital and system-wide policies regarding licensed independent practitioners in the hospital setting required.
Preferred: MDStaff or other credentialing database experience
Exceptional attention to detail
Exceptional verbal and written communication skills

Benefits

Comp & perks

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program
Opportunity for annual increases based on performance

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

credentialingapplication processingquality controldocumentationdata entryprivilege evaluationinvestigationverificationauditingproblem-solving

Soft Skills

communicationorganizationalattention to detailteam playerself-motivated

Certifications

Certified Provider Credentialing Specialist (CPCS)