Credentialing Coordinator (Remote)

Description & Requirements

Maximus is seeking a detail-oriented and organized Credentialing Coordinator to join our team. In this role, you will support the credentialing and recredentialing process for independent contractors, verifying credentials, and maintaining accurate records across multiple databases. The ideal candidate will have strong organization and communication skills, a keen eye for accuracy, and the ability to follow established guidelines while ensuring compliance with health plan requirements. This is an excellent opportunity for someone looking to build experience in healthcare administration and credentialing while contributing to a team that values precision, accountability, and service.

Why Maximus?

- Work/Life Balance Support - Flexibility tailored to your needs!

- • Competitive Compensation -Bonuses based on performance included!

- • Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance.

- • Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching.

- • Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.

- • Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).

- • Recognition Platform - Acknowledge and appreciate outstanding employee contributions.

- • Tuition Reimbursement - Invest in your ongoing education and development.

- • Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.

- • Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs.

- • Professional Development Opportunities-Participate in training programs, workshops, and conferences.

- •Licensures and Certifications-Maximus assumes the expenses associated with renewing licenses and certifications for its employees.

Essential Duties and Responsibilities:

- Process applications and initial as well as re-credentialing paperwork.

- Maintain knowledge of current health plan requirements for credentialing providers including managing delegated health plans.

- Complete provider credentialing and recredentialing applications in accordance with guidelines; monitor applications and follow up as needed.

- Set up and maintain provider information in online credentialing databases and system.

- Collect credentials of incoming providers as per work instructions.

- Perform primary source verifications of all practitioner credentials.

- Perform data enter into various systems used to credential and recredentiale staff.

- Maintain necessary logs, lists, records, and current documentation required for provider credentialing.

- Provide regular reports on pending staff and those who have cleared credentialing.

Minimum Requirements

- High school diploma or GED required and 0-2 years of relevant professional experience required, or equivalent combination of education and experience.

- Strong data entry and telephone skills preferred.
- Previous experience in claims review or claims auditor preferred.
- Previous experience in customer service and call center preferred.

-A minimum of two (2) years of Customer Service experience

-A minimum of two (2) years of credentialing experience as it relates to new hires (i.e. license verification, background and reference checks, etc).

-Strong administrative and organizational skills in a fast-paced environment

-Ability to multi-task effectively

-Proficiency in MS Office Suite

Preferred Requirements

-Previous experience with Smartsheet

-Previous experience working with Independent Contractors/Staffing Agencies

-Previous experience with COUPA

-Previous recruiting experience

Home Office Requirements

-Maximus provides company-issued computer equipment

-Reliable high-speed internet service

-Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity

-Minimum 5 Mpbs upload speeds

-Private and secure workspace

#ClinicalServices #LI-Remote

EEO Statement


Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.

Pay Transparency


Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.

Minimum Salary


$

22.50

Maximum Salary


$

25.00