Coordinator - Credentialing & Privileging

Coordinator - Credentialing & Privileging (Job Overview)

Join us as we pioneer a new era in healthcare credentialing at Legacy Community Health. As the Credentialing & Privileging Coordinator, you'll be at the forefront of digital transformation, leveraging cutting-edge technology to streamline the onboarding and credentialing process for our healthcare providers.

Be a vital player in the dynamic healthcare ecosystem, ensuring seamless compliance with Medicare and other regulatory standards. Collaborate with external organizations to revolutionize provider onboarding and payor enrollment functions. Empower healthcare professionals by maintaining accurate, data-driven credentialing and privileging information. Drive innovation and continuous improvement in credentialing processes to enhance operational efficiency. Contribute to community health impact by ensuring our providers meet the highest standards of care.

Key Responsibilities

• Innovatively obtain and verify credentialing information from multiple primary sources, aligning with cutting-edge federal and state standards.
• Ensure regulatory compliance through agile application management and primary source verification.
• Lead the onboarding process for providers, integrating advanced document requests and verification methods.
• Serve as the tech-savvy contact for provider onboarding and privileging, optimizing review activities with digital tools.
• Maintain credentialing files and data systems, enhancing compliance with group delegation and audit requirements.
• Orchestrate credentialing audits, ensuring alignment with managed care delegated credentialing contracts.
• Leverage digital platforms for maintaining up-to-date privileging data, optimizing the expirable process management.
• Utilize CAQH and other technologies to ensure accurate provider records and proactive notification of expiring credentials.
• Deliver data-driven reports to the SVP of Compliance and facilitate impactful board presentations on privileging.
• Drive continuous improvement in credentialing standards through strategic file reviews and policy development.

Minimum Qualifications

About Legacy Community Health

As the largest Federally Qualified Health Center (FQHC) in Southeast Texas, Legacy Community Health has been delivering comprehensive, high-quality, and affordable health care for nearly 40 years. With more than 50 clinics across the Greater Houston and Gulf Coast region, we continue to grow strategically and invest in our communities. By innovating how care is delivered, we've stayed at the forefront of connecting our communities to healthevery day, in every way. At Legacy, we know our success is powered by our people. We're always looking for talented, passionate individuals who want more than a jobthey want a meaningful career that makes a real impact. Explore our open positions and see if a career at Legacy is right for you.

Approachable & Collaborative

We bring our expertise without ego. In a collaborative healthcare environment, humility fosters trust and teamwork. Our employees value diverse perspectives, seek input from others, and are unafraid to acknowledge when they need help. We stay grounded in our purpose : to serve patients and communities with compassion and humility.

Driven & Committed

We are driven by a deep commitment to excellence in patient care and organizational improvement. Our employees take initiative, embrace challenges, and go the extra mile to support our mission. Whether improving patient outcomes, streamlining processes, or stepping up in times of need, we are always striving to drive healthy changewithin ourselves, our teams, and the communities we serve.

Perceptive & Thoughtful Communicators

We value emotional intelligence as much as clinical or technical skill. Our team members demonstrate sound judgment, cultural sensitivity, and the ability to navigate complex situations with empathy and professionalism. They communicate clearly and respectfully with patients, families, and colleagues, building trust and fostering a safe, inclusive environment for all.