Credentialing Coordinator {174787}

Credentialing Specialist

Location: Farmers Branch, TX
Pay Rate: $17.00–$18.50/hour on W-2

Position Overview

We are seeking a detail-oriented Credentialing Specialist to support the credentialing and re-credentialing of healthcare clinicians. This position is responsible for reviewing provider applications, completing primary source verifications, maintaining credentialing records, and ensuring files meet applicable regulatory and accreditation requirements.

The ideal candidate will have previous healthcare credentialing experience, familiarity with NCQA standards, and the ability to manage a high volume of detailed documentation while communicating professionally with providers and internal teams.

Key Responsibilities

• Review and process clinician credentialing and re-credentialing applications.
• Perform primary source verification of provider credentials and required documentation.
• Maintain accurate and complete credentialing files in accordance with established policies and timelines.
• Verify and maintain current state licenses, DEA certificates, malpractice insurance, and other required provider documentation.
• Review background checks, drug screenings, and TB screening results and accurately document findings.
• Query appropriate organizations and evaluate responses to verify provider compliance with credentialing requirements.
• Confirm provider eligibility and requirements for participation in specific states and health plans.
• Assemble completed credentialing files and prepare documentation for Credentialing Committee review.
• Support ongoing monitoring of contracted clinicians.
• Maintain accurate provider information within the MD Staff credentialing database.
• Run database queries and reports to support credentialing operations and identify outstanding requirements.
• Communicate with clinicians regarding incomplete applications, missing documentation, and credentialing requirements.
• Provide timely and professional responses to internal and external inquiries.
• Provide administrative support to Credentialing leadership and other stakeholders as needed.
• Maintain the privacy and security of protected health information (PHI).
• Assist with special projects and other credentialing activities as assigned.

Required Qualifications

• 1–3 years of experience in healthcare credentialing.
• Familiarity with NCQA accreditation and credentialing standards.
• Intermediate proficiency with Google Workspace applications.
• Strong attention to detail and ability to maintain accurate records.
• Excellent organizational and time-management skills.
• Strong written and verbal communication skills.
• Ability to prioritize multiple credentialing files and deadlines.
• Strong interpersonal skills with the ability to work effectively with clinicians and internal stakeholders.
• Ability to appropriately handle confidential and protected health information.

Preferred Qualifications

• Experience with the MD Staff credentialing database or a similar credentialing platform.
• Familiarity with URAC guidelines.
• Experience with primary source verification.
• Knowledge of healthcare provider licensing, DEA documentation, malpractice coverage, and credentialing requirements.
• Certified Provider Credentialing Specialist (CPCS) certification or interest in obtaining CPCS certification once eligible.

Education

• High school diploma or equivalent required.