Credentialing Coordinator

Whatever the role, everyone at Grady is part of something bigger. Choosing a career at Grady is choosing to be part of a legacy of service and commitment to our communities. If you want to make a difference, we want to hear from you.

Job Summary

The Credentialing Coordinator is responsible for all aspects of initial credentialing/privileging and recredentialing/privileging of physicians and advanced practice providers who perform patient care services at Grady Health System. The Credentialing Coordinator independently gathers, conducts and analyzes data/information via the primary source in accordance with the credentialing/privileging standards of all applicable accrediting and regulatory agencies (TJC, NCQA, State, and Federal) as well as the Grady Health System Medical Staff Bylaws and Rules and Regulations and Grady Health System policies and procedures. Performs the initial and re-credentialing of Grady employed providers with all managed care plans and third-party payors through delegated processes in accordance with standards of the Grady Health System policies and procedures, Medical Staff Bylaws, and Grady Managed Care contracts.

RESPONSIBILITIES:

* Communicates completion of the applications to the Medical Staff Services Director and appropriate review by the Service Chiefs.

* Assists with FPPE and OPPE collection.

* Coordinates the credentialing/ privileging process for assigned physicians and advanced practice providers

* Acts independently to process credentialing/ privileging applications for physicians and advanced practice providers.

* Maintains thorough understanding of TJC, NCQA and state/federal regulatory credentialing/privileging standards.

* Responsible for the quality and integrity of provider files and meets processing quality and productivity standards.

* Performs routine file audits. Serves as a liaison for physicians and advanced practice providers navigating through the health system.

* Adheres to strict confidentiality requirements

* Analyzes provider applications for completeness, accuracy, consistency, gaps in work history, relevant references, etc.

* Verifies all credentialing/privileging elements, including but not limited to, education, training, board certification, work history, licensure and certifications, case/procedure logs, malpractice coverage, etc through a variety of primary sources as deemed appropriate per TJC standards and other applicable accrediting agencies.

* Identifies/concerns issues and initiates further data collection as needed.

* Initiates appropriate and timely follow-up information from the Medical Staff Services Department or other sources as needed.

QUALIFICATIONS:

Must possess and maintain a working knowledge of The Joint Commission, NCQA and state/federal accrediting agencies requirements/standards regarding credentialing/privileging.

Three years of credentialing/privileging experience in a hospital or managed care setting and/or Medical Staff Services, Two years of database experience.

OR

Three years minimum in progressively responsible positions in a complex business/administrative office setting, which includes working with physicians, advanced practice providers or other professional groups

EDUCATION:

Associate degree

Core Competencies
These competencies reflect the values and behaviors expected of all Grady team members, regardless of role. They ensure that every employee contributes to safe, high-quality care, positive patient experience, and a collaborative work environment.

1. Patient-Centered Care - Demonstrates a commitment to delivering safe, compassionate, and high-quality care that prioritizes the well-being and satisfaction of patients and their families.
2.Integrity & Accountability - Acts ethically, maintains confidentiality, and accepts responsibility for actions, decisions, and outcomes.
3.Collaboration & Teamwork - Builds positive relationships, works effectively across departments, and supports colleagues to achieve shared goals.
4. Communication - Communicates clearly, respectfully, and effectively with patients, families, colleagues, and leadership.
5.Respect & Inclusion - Creates an inclusive environment by valuing diversity, treating others with dignity, and ensuring equitable care and opportunities for all.
6. Quality & Safety - Adheres to best practices, regulatory standards, and policies to ensure safe, reliable, and high-quality outcomes.
7. Adaptability & Resilience - Responds effectively to change, remains flexible in dynamic situations, and demonstrates resilience under pressure.
8. Continuous Improvement - Seeks opportunities to improve processes, skills, and outcomes through innovation, learning, and feedback.
9. Leadership & Professionalism - Inspires, guides, and develops individuals and teams while modeling professionalism, fairness, and transparency.
10. Employee Experience Focus - Champions a supportive and engaging employee journey that enables staff to thrive and, in turn, deliver exceptional patient care.

Grady Total Rewards
At Grady, we believe in supporting the health, well-being, and growth of every team member. Our Total Rewards package is designed to provide competitive pay and comprehensive benefits that make a difference in your life and career, including:

• Health & Wellness: Medical, dental, vision, and prescription drug coverage.

• Financial Security: Retirement savings plans with employer contributions, life insurance, and disability coverage.

• Work-Life Balance: Paid time off, holidays, and family leave benefits.

• Career Growth: Tuition reimbursement, professional development programs, and opportunities for advancement.

• Employee Support: Employee Assistance Program (EAP), wellness initiatives, and discounts on services.

Grady's Total Rewards are designed to ensure our employees feel valued, supported, and empowered, both at work and beyond.

Why Join Grady?
Grady Health System is more than a hospital - we are a vital part of Atlanta and the surrounding communities. For over 125 years, Grady has been committed to providing exceptional care, advancing health equity, and making a difference in the lives of those we serve. When you join Grady, you become part of a team that values excellence, compassion, innovation, and collaboration.

Here, every role matters. Whether you provide direct patient care, support our operations, or lead teams, you play an important part in fulfilling our mission. We offer opportunities to learn, grow, and build a meaningful career in an environment where your contributions are recognized and valued.

At Grady, we don't just work, we make an impact.

Equal Opportunity Employer Statement:
Grady Health System is proud to be an equal opportunity employer. We are committed to fostering a workforce where all employees feel valued, respected, and empowered to succeed. We prohibit discrimination and harassment of any kind based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other legally protected characteristic.

Grady is dedicated to creating an accessible work environment and provides reasonable accommodations to qualified individuals with disabilities to ensure equitable opportunities for success.