Provider Credentialing Specialist

Provider Credentialing Specialist Valora Medical Center

LLC - 2.4

Irving, TX Job Details Full-time 6 hours ago Benefits Free parking Health savings account AD&D insurance Disability insurance Health insurance Dental insurance 401(k) Flexible spending account Paid time off Employee assistance program Vision insurance 401(k) matching Life insurance Referral program Retirement plan Qualifications Employee onboarding Record keeping Spanish Teamwork Medicare Accreditation standards (regulatory compliance area) Interpersonal skills Medical office experience Healthcare Administration Certified Provider Credentialing Specialist Mid-level EMR/EHR Talent pipeline development Analysis skills Bachelor's degree Attention to detail Task prioritization Decision making Conflict management Organizational skills Bachelor's degree in healthcare administration 4 years Onboarding process management Medical terminology Healthcare compliance Communication skills Full Job Description Valora Medical Group is a high-performing, risk-based primary care provider group focused on delivering exceptional patient outcomes while managing healthcare resources efficiently. At Valora, we believe exceptional care begins with exceptional people, and we're proud to support a culture of collaboration, innovation, accountability, and integrity. We are seeking a detail-oriented and proactive Provider Credentialing and Onboarding Specialist to support our growing medical group. This role is responsible for ensuring all providers are credentialed, enrolled, compliant, and fully onboarded to begin seeing patients efficiently. This position plays a critical role in reducing time to revenue, maintaining compliance, and supporting provider growth across multiple markets. Your efforts will support the organization's commitment to high-quality care by maintaining accurate provider records, verifying credentials and recredentialing, and facilitating smooth onboarding procedures. This position will work closely with the Human Resources, Operations, and Revenue Cycle.

Essential Duties and Responsibilities:

Credentialing & Payer Enrollment Manage end-to-end provider credentialing and enrollment with Medicare, Medicare Advantage, and commercial payers Maintain and update CAQH profiles Track and manage recredentialing cycles Monitor provider licenses, DEA registrations, and expirations Follow up with payers to ensure timely application processing Provider Onboarding & Readiness Coordinate onboarding to ensure providers are fully set up and ready to see patients Facilitate access to systems including eClinicalWorks (ECW), billing platforms, and payer portals Partner with Operations, HR, and Revenue Cycle teams to ensure smooth onboarding Track provider readiness and activation timelines Malpractice & Compliance Tracking Maintain and monitor provider malpractice insurance (coverage, expirations, COIs) Ensure continuous coverage with no lapses Track CME requirements and compliance deadlines Monitor and report completion of required compliance trainings (e.g., HIPAA) Physician Outreach & Coordination Conduct outbound outreach to physicians to introduce opportunities and coordinate interviews Maintain and update candidate pipeline tracker Schedule interviews with leadership and follow up with candidates

Additional Responsibilities:

Perform other duties as assigned to meet business and departmental needs.

Performance Expectations:

Reduce time from provider hire to first patient visit Ensure 100% provider credentialing and enrollment accuracy Maintain zero lapses in malpractice coverage Achieve full compliance in CME and training requirements Maintain organized tracking of provider onboarding and recruitment pipeline

Qualifications/Education:

Bachelor's degree in Health Administration, or related healthcare field 4+ years of proven experience in provider credentialing, enrollment, or healthcare operations Experience with multi-payer enrollment (Medicare Advantage preferred) Strong understanding of medical terminology and healthcare documentation processes. Familiarity with CAQH, PECOS, and payer portals Familiarity with NCQA standards and accreditation requirements is highly desirable. Previous medical office experience is preferred to understand clinical workflows and provider needs Excellent organizational skills with attention to detail and accuracy. Strong communication skills, both verbal and written, and ability to influence Ability to communicate effectively with providers, insurance representatives, and internal teams Ability to manage multiple priorities in a fast-paced environment Ability to make decisions in a timely fashion that are sound, accurate, and supported by the reasoning and inclusion of the appropriate people Must be able to prioritize and accomplish multiple tasks and objectives at an acceptable level in a fast-paced environment Ability to establish working relationships, resolve interpersonal conflicts, and apply basic staff etiquette in dealing with others Ability to handle confidential information with discretion Exceptional analytical skills with attention to detail Ability to learn new procedures and quickly adapt to change Innovative, motivated, organized, and team player Follow through with commitments Ability to work independently and in a fast-paced environment Proactive and self-starter Why Join Us? Competitive salary + performance bonus Comprehensive benefit package (medical, dental, vision, disability, voluntary life and AD&D insurance, and supplemental benefits) Competitive 401(k) with employer match after 90-days Paid time off and professional development opportunities Mission-driven organization with a culture of innovation and teamwork High-growth medical group focused on value-based care Opportunity to play a key role in provider expansion and operational success Direct impact on provider onboarding, compliance, and revenue readiness Collaborative and fast-paced environment with strong leadership support

EEO Statement:

Valora Medical Group, LLC is an equal opportunity employer and does not discriminate on the basis of race, color, religion, creed, sex, national origin, age, disability, pregnancy status, sexual orientation, gender identity, veteran status, marital status, genetic information, citizenship status, or other status protected by law. In compliance with the Immigration Reform and Control Act of 1986, we will hire only U.S. citizens and aliens lawfully authorized to work in the United States.

Benefits:

401(k) 401(k) matching AD&D insurance Dental insurance Disability insurance Employee assistance program Flexible spending account Free parking Health insurance Health savings account Life insurance Paid time off Referral program Retirement plan Vision insurance Application Question(s): What is your desired pay rate? Briefly describe your experience with provider credentialing and enrollment:

Education:

Bachelor's (Preferred)

Experience:

Provider credentialing: 4 years (Preferred) e

ClinicalWorks EMR System:

2 years (Preferred) multi-payer enrollment (Medicare Advantage preferred): 4 years (Preferred) medical license management: 4 years (Preferred) working with CAQH and credentialing platforms: 4 years (Preferred)

Language:

Spanish (Preferred)

License/Certification:

Certified Provider Credentialing Specialist (Preferred) Ability to

Commute:

Irving, TX 75038 (Required)

Work Location:

In person