Full Time or Part Time.
Remote or in person in Fort Worth area.
Job Summary:
We are seeking a detail-oriented Credentialing Specialist to manage and maintain provider credentialing and payer enrollment processes. This role ensures that all clinicians are properly credentialed with insurance carriers, government programs, and regulatory agencies so services can be billed and reimbursed efficiently. The ideal candidate is organized, proactive, and experienced in healthcare credentialing processes.
Key Responsibilities:
- Manage the credentialing and re-credentialing process for providers with commercial insurance plans, Medicare, Medicaid, and workers’ compensation networks.
- Prepare and submit provider enrollment applications and supporting documentation to insurance carriers and regulatory agencies.
- Track credentialing status and maintain accurate records of provider licenses, certifications, malpractice insurance, and other required documents.
- Monitor and maintain CAQH profiles ensuring all provider information is accurate and up to date.
- Follow up with payers to ensure timely processing of credentialing applications.
- Maintain a credentialing database and create reports for leadership as needed.
- Coordinate with clinic leadership and billing teams to ensure providers are enrolled prior to treating patients.
- Ensure compliance with federal, state, and payer credentialing requirements.
- Assist with audits and maintain documentation for regulatory compliance.
Qualifications
- 2+ years of healthcare credentialing or provider enrollment experience preferred.
- Knowledge of Medicare, Medicaid, and commercial payer enrollment processes.
- Experience with CAQH, PECOS, and payer portals preferred.
- Strong organizational skills with high attention to detail.
- Ability to manage multiple applications and deadlines simultaneously.
- Proficiency in Microsoft Office (Excel, Word) and credentialing software systems.
- Excellent communication and follow-up skills.
Preferred Qualifications:
- Experience working with physical therapy clinics or outpatient healthcare organizations.
- CPCS (Certified Provider Credentialing Specialist) certification is a plus.
Benefits:
- Competitive salary
- Health, dental, and vision insurance
- Paid time off and holidays
- Opportunities for professional growth
- Flexible or hybrid work options
How to Apply:
Interested candidates should submit their resume and a brief cover letter outlining their credentialing experience.