Credentialing Specialist for Provider Compliance & Growth

Central Health; Austin (TX); On-site; USD 42,000 - 66,000; Full time

Job summary

Central Health in Austin, TX, is seeking a Credentialing Specialist to manage credentialing and re-credentialing for all providers. The role collaborates across departments to ensure compliance with TDI, NCQA, CMS, and Sendero policies, and participates in software implementations.

The ideal candidate is detail-oriented, can work independently, and has at least two years of healthcare credentialing experience.

Qualifications

• High School Diploma or equivalent (higher degree accepted).
• 2 years credentialing in healthcare setting.

Responsibilities

• Coordinate and maintain the credentialing and re-credentialing process for all providers.
• Process, update and maintain provider files, review and load data into the credential database.
• Obtain primary source verification of education, licensure, work experience, and other relevant qualifications.
• Ensure compliance with regulatory standards (e.g., TDI, NCQA, CMS).
• Assist with regulatory audits and software implementations.
• Develop standards and best practices for credentialing systems and identify improvement opportunities.

Skills

Microsoft Office

Credentialing software

Detail-oriented

Communication skills

Education

High School Diploma or equivalent

Tools

Credentialing software

Job description

Central Health in Austin, TX, is seeking a Credentialing Specialist to manage credentialing and re-credentialing for all providers. The role collaborates across departments to ensure compliance with TDI, NCQA, CMS, and Sendero policies, and participates in software implementations.

The ideal candidate is detail-oriented, can work independently, and has at least two years of healthcare credentialing experience.