Credentialing Specialist

Call-On-Doc; Irving (TX); Remote; USD 60,000 - 75,000; Full time

Benefits offered by this job

Fully remote

Training provided

40 hours per week

Job summary

CallonDoc is seeking an experienced Credentialing Specialist to own provider credentialing and payer enrollment for the CallonDoc organization and the DFW clinic. The role involves independent handling of complex enrollments, ensuring quality, and guiding teammates in credentialing practices.

Reporting to the Supervisor of Licensing & Credentialing, you will manage timelines, maintain records, and verify payer requirements while coordinating with Licensing, HR and clinical teams.

Qualifications

• Minimum of 4 years of direct provider credentialing experience.
• Independent management of credentialing and payer enrollment.

Responsibilities

• Independently prepare, submit and track initial credentialing and payer enrollment for providers and entities.
• Resolve application deficiencies, enrollment delays and payer discrepancies.
• Support credentialing for CallonDoc and the DFW clinic, including prescriptive-only enrollment.
• Review applications and supporting documents for accuracy and completeness.
• Provide technical guidance and training to credentialing teammates.
• Research state and payer requirements.
• Maintain provider profiles, payer portal records and rosters.
• Coordinate provider additions, terminations and demographic updates.
• Monitor deadlines, approvals, effective dates and continued enrollment.

Skills

Spreadsheet management

Credentialing portal usage

Professional communication

Time management

Education

Associate or Bachelor’s in healthcare administration or related field

High school diploma or GED

Tools

CAQH

PECOS

Google Workspace

Job description

CallonDoc is looking for an experienced Credentialing Specialist to own provider credentialing and payer enrollment for CallonDoc and our DFW clinic. You will work independently on complex enrollments, review application quality, and provide technical guidance to teammates in credentialing. This role reports to the Supervisor of Licensing & Credentialing.

Responsibilities

• Independently prepare, submit and track initial credentialing, payer enrollment, recredentialing and revalidation for providers and entities.
• Resolve application deficiencies, enrollment delays and payer discrepancies.
• Support credentialing for CallonDoc and the DFW clinic, including prescriptive-only enrollment.
• Review applications and supporting documents for accuracy and completeness.
• Provide technical guidance and training support to other credentialing team members.
• Research state and payer requirements.
• Maintain provider profiles, payer portal records, rosters and files.
• Complete payer outreach monthly from September to March and quarterly from April to August.
• Verify clinic demographics quarterly and submit changes as needed.
• Coordinate provider additions, terminations, demographic changes and supervising physician updates.
• Monitor deadlines, approvals, effective dates and continued enrollment.
• Maintain trackers and report barriers and deadlines to your supervisor.
• Update SOPs, workflows and training materials.
• Coordinate with Licensing, HR/Recruiting and clinical teams.

Required qualifications

• High school diploma or GED.
• Minimum of 4 years of direct provider credentialing experience.
• Ability to independently manage credentialing and payer enrollment.
• Direct experience using credentialing and enrollment portals.
• Strong spreadsheet and electronic-record management skills.
• Initiative, determination, professional communication and consistent follow-through.
• Availability to work Monday–Friday, 8:00 AM–4:00 PM Central Time.

Preferred qualifications

• Associate’s or bachelor’s degree in healthcare administration, business administration or a related field.
• Certified Provider Credentialing Specialist (CPCS) certification.
• Experience with clinic credentialing, payer enrollment, Medicaid enrollment and multistate credentialing.

No professional license or certification is required. Training is provided on our workflows, unfamiliar payer portals and prescriptive-only enrollment processes.

Systems

Google Workspace, department trackers, payer portals, CAQH, PECOS where applicable, and state Medicaid enrollment systems.

Work environment

Fully remote. Full-time, 40 paid hours per week, with a 30-minute lunch. No routine weekend or on-call coverage.