Credentialing & Payer Compliance Specialist

United Against Human Trafficking; Houston (TX); On-site; USD 42,000 - 65,000; Full time

Job summary

Cenikor is seeking an Insurance Billing Specialist for our Corporate Office in Houston, TX. The role focuses on primary source verification of credentials, processing third-party payer documentation, and maintaining accurate provider data. You will support audits, ensure regulatory compliance, and maintain payer contracts while upholding Cenikor's mission-driven culture.

Schedule is Monday–Friday, 8am–5pm. Experience with Medicaid/Medicare billing and credentialing is preferred.

Qualifications

• Skilled in administrative and clerical procedures.
• Skilled in Microsoft Office and ten-key.
• The ability to possess excellent organization and communication skills.
• Ability to be detail oriented and accurately record numerical data.
• Ability to possess a attitude.
• Ability to work in a team environment.
• Knowledge of Microsoft Office software required, including specific MS Outlook calendar experience.
• Ability to consistently uphold the Core Principles of Cenikor's Culture: mission of service, respectful communication, self-motivation, professional boundaries, teamwork.

Responsibilities

• Perform PSV of credentials including licenses, certifications, education and training.
• Track, organize and process documentation related to third party payer contracts.
• Maintain credentialing, applications and licenses; perform audits and reviews.
• Communicate with Payer Relations Manager to optimize payer communications and credentialing.
• Maintain NPI registry with updated demographics for facilities and clinicians.
• Monitor compliance with third party payer obligations and renewals; onboard new payer contracts.
• Ensure compliance with federal, state, local regulations and accrediting standards.
• Provide support for audits and related arrangements.
• Maintain payer contracts/files and related databases; keep contract summaries updated.
• Maintain training compliance including state-regulated certifications.
• Complete Big 5 performance tool by deadlines and use SMART goals for reviews.
• Adhere to HIPAA; maintain confidentiality and escalate issues.
• Uphold Cenikor culture and contribute to a positive work environment.
• Perform additional duties as assigned.

Skills

Administrative procedures

Microsoft Office

Organization

Detail oriented

Teamwork

Education

High School Diploma

Associate degree

Tools

MS Outlook

Ten-key

Job description

Cenikor is seeking an Insurance Billing Specialist for our Corporate Office in Houston, TX. The role focuses on primary source verification of credentials, processing third-party payer documentation, and maintaining accurate provider data. You will support audits, ensure regulatory compliance, and maintain payer contracts while upholding Cenikor's mission-driven culture.

Schedule is Monday–Friday, 8am–5pm. Experience with Medicaid/Medicare billing and credentialing is preferred.