Hi,
One of our clients is looking for Senior Credentialing Specialist in Houston, TX
Title: Senior Credentialing Specialist
Location: Houston, TX (Onsite Position)
Duration: 12 Months
Job Description:
We are seeking an experienced Senior Credentialing Specialist with expertise in CVO (Credentials Verification Organization) operations, Provider Credentialing, and Provider Enrolment. The candidate will be responsible for managing the end-to-end credentialing lifecycle, including Primary Source Verification (PSV), regulatory compliance, provider onboarding, re-credentialing, and payer enrolment activities.
Key Requirements:
- 5 – 8 years of experience in provider credentialing and CVO operations.
- Strong experience in PSV, CAQH, provider enrolment, and re-credentialing.
- Knowledge of NCQA, CMS, Joint Commission, OIG, and SAM compliance requirements.
- Experience verifying provider licenses, education, certifications, work history, malpractice coverage, and sanctions screening
- Hands-on experience with credentialing platforms
- Ability to manage credentialing files, support committee reviews, maintain provider data, and ensure SLA adherence
Preferred Background: Candidates from healthcare payers, hospitals, health systems, managed care organizations, or credentialing service providers with relevant certifications (CPCS, CPMSM) are highly preferred
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