Credentialing and Provider Enrollment Coordinator

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Ascension

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🤝 Non-profit

Healthcare • Non-profit

Ascension is one of the nation’s leading non-profit Catholic health systems focused on delivering compassionate, personalized care with special attention to vulnerable populations. In FY2025 Ascension reported providing $1. 7 billion in care for persons living in poverty and other community benefit programs plus $1. 8 billion of unreimbursed care for Medicare patients. Operating across 16 states and the District of Columbia, its network includes about 97,300 associates, 25,300 aligned providers, 90 wholly owned or consolidated hospitals and ownership interests in 29 additional hospitals; Ascension also operates 22 senior living facilities and a variety of other care sites (including home health and health clinics). Its specialties include medical services, nursing, health system operations, and healthcare technology, all grounded in its faith-based mission to bring health, healing and hope to all.

📋 Description

• Complete day-to-day credentialing and re-credentialing for all providers • Ensure provider files from ACVS meet managed care criteria • Complete state-specific credentialing verifications • Send newly credentialed rosters to delegated payers • Complete and submit CAQH applications to non-delegated payers • Run rosters for delegated audits and assist with credentialing/enrollment audits • Process provider data updates, changes, and terms in MD Staff • Submit provider data updates to payers monthly • Follow up with payers to ensure new providers are loaded timely and correctly • Produce documentation to meet payer and NCQA guidelines • Stay current on regulatory, legal, and legislative requirements and communicate changes

🎯 Requirements

• High School diploma equivalency OR 1 year of applicable cumulative job-specific experience required • Required professional licensure/certification may be used in lieu of education or experience, if applicable • 2 or 3 years of delegated credentialing experience strongly preferred • 2 or 3 years of health plan experience strongly preferred • Ability to complete state-specific credentialing verifications • Knowledge of managed care criteria, payer requirements, and NCQA guidelines • Ability to use CAQH, MD Staff, and payer roster systems • Ability to monitor regulatory, legal, and legislative requirements

🏖️ Benefits

• Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options • Employer-matched 403(b) • Planning and hardship resources • Disability and life insurance • Pro-rated paid time off (PTO) and holidays • Ascension-paid tuition (Vocare) • Reimbursement • Ongoing professional development and online learning • Employee Assistance Program • Counseling and peer support • Spiritual care and stress management resources • Parental leave • Adoption assistance and family benefits • Optional legal and pet insurance • Transportation savings