Credentialing & Compliance Coordinator in CampHIll, Pennsylvania at Orthopedic Surgeons LTD

SUMMARY OF DUTIES: The Credentialing & Compliance Coordinator manages provider credentialing, recredentialing, privileging, payer enrollment, and key organizational compliance activities. This position maintains accurate provider and compliance records, monitors regulatory requirements and deadlines, supports audits and accreditation activities, and coordinates compliance initiatives to ensure adherence to applicable healthcare regulations and organizational policies.

ESSENTIAL FUNCTIONS:

• Coordinate provider credentialing, recredentialing, privileging, payer enrollment, and revalidation activities.
• Collect, verify, and maintain required provider documentation and credentialing files.
• Complete and maintain Medicare, Medicaid, commercial payer, CAQH, and other enrollment requirements.
• Monitor provider licenses, certifications, enrollments, and other regulatory expirations to ensure timely renewal.
• Serve as a liaison with providers, payers, CVOs, regulatory agencies, and internal departments regarding credentialing and compliance matters.
• Maintain compliance records, calendars, BAAs, provider disclosures, signature delegations, and required documentation.
• Coordinate mandatory training, compliance audits, safety/OSHA activities, SDS requirements, and compliance signage.
• Track compliance incidents and assist with developing and updating compliance policies and procedures.
• Coordinate Compliance Committee meetings and maintain related documentation and follow-up items.
• Prepare reports and support regulatory, accreditation, and compliance audits.
• Collaborate with Human Resources, Medical Staff, Compliance, Revenue Cycle, Operations, and Leadership to support provider onboarding and ongoing compliance.
• Assist the OIP Credentialing & Compliance Coordinator
• Maintain confidentiality and perform other credentialing and compliance duties as assigned.

EXPERIENCE & EDUCATION:

• Minimum of 2 years of credentialing experience
• Associate degree in Healthcare Administration, Business Administration, or a related field preferred.