Position Overview
This role focuses on maintaining the integrity of provider credentialing data and ensuring adherence to regulatory and organizational standards. Based in Richardson, TX, the Credentialing Specialist plays a key part in verifying provider qualifications and supporting timely network enrollment.
Key Responsibilities
- Verify the accuracy and completeness of provider information before submission to credentialing committees.
- Conduct regular audits of documentation required for network participation and regulatory compliance.
- Monitor credentialing workflows to ensure all necessary forms and verifications are current and properly filed.
- Support the timely onboarding of approved providers into provider networks.
- Generate reports to track credentialing status and identify potential delays or gaps.
Required Qualifications
- High school diploma or equivalent
- At least three years of relevant work experience
- Minimum of nine months in credentialing, provider services, or customer-facing roles
- Proficiency with Windows, Microsoft Word, Excel, and business databases
- Strong written and verbal communication abilities
- Effective organizational and multitasking skills with sound judgment
Preferred Skills
- Familiarity with NCQA, managed care organization (MCO), or CVO standards
- Experience using RNPS, PIP, or comparable provider data systems
Work Environment
This is an onsite position located in Richardson, TX. The specialist will work directly with credentialing teams and regulatory documentation, requiring consistent attention to detail and process adherence.
Compensation
The hourly rate for this role is $15.00. No equity or additional compensation components are included.
