Credentialing Specialist

Credentialing Specialist Omega RCM Solutions - 5.0 Webster, TX Job Details Full-time 1 day ago Benefits Health insurance Dental insurance Paid time off Vision insurance Qualifications Microsoft Excel Administrative experience High school diploma or GED Medical administrative support Organizational skills Full Job Description Credentialing Specialist The Credentialing Specialist will report to the credentialing supervisor and/or office supervisor and is responsible for managing provider enrollment, credentialing, recredentialing, and payer participation processes to ensure timely and accurate provider enrollment with insurance plans, healthcare networks, and facilities. Position Overview The Credentialing Specialist serves as a liaison between providers, insurance plans, hospitals, and internal departments to coordinate and maintain provider credentialing and enrollment activities. This position focuses on insurance payer enrollment and requires strong attention to detail, organization, and follow-up skills to ensure providers remain active and compliant with participating health plans and facilities. The ideal candidate is highly organized, proactive, and experienced in managing multiple credentialing applications and payer relationships in a fast-paced healthcare environment. Essential Duties & Responsibilities Coordinate and manage provider credentialing, recredentialing, and enrollment with insurance plans Initiate, complete, and submit provider applications to insurances, healthcare networks and hospitals Maintain accurate and current provider demographic, licensure, and credentialing information Obtain required documentation and signatures for credentialing and enrollment applications Follow up with insurances and facilities regarding application status, deficiencies, and participation approvals Track credentialing and enrollment applications to ensure timely completion and prevent participation delays Verify provider licenses, certifications, malpractice coverage, and other required credentialing documentation Maintain accurate documentation, credentialing notes, and status updates within internal tracking systems and spreadsheets Assist with provider roster maintenance and monthly network participation updates Scan, upload, and organize credentialing documents and correspondence Respond to incoming calls and emails professionally and timely Maintain confidentiality and comply with HIPAA and organizational policies Perform additional administrative or credentialing-related duties as assigned Qualifications High School Diploma or equivalent required Minimum of 6 months of healthcare credentialing, provider enrollment, or medical administrative experience preferred Experience working with insurance payers, provider enrollment, or healthcare credentialing Familiarity with Medicare, Medicaid, and commercial insurance enrollment processes is a plus Skills & Competencies Strong attention to detail and organizational skills Ability to manage multiple projects and deadlines simultaneously Excellent written and verbal communication skills Strong follow-up and problem-solving abilities Ability to work independently and in a fast-paced environment Professional demeanor and positive attitude Customer service oriented Proficient in Microsoft Word, Excel, Outlook, and general computer applications Ability to maintain confidentiality and handle sensitive information appropriately Disclaimer This job description is intended to provide a general overview of the position and does not represent a comprehensive list of all duties, responsibilities, or qualifications required. Management reserves the right to modify, assign, or remove duties as business needs change.

Benefits:

Dental insurance Health insurance Paid time off Vision insurance

Experience:

Administrative:

2 years (Preferred) Ability to

Commute:

Webster, TX 77598 (Preferred)

Work Location:

In person