Healthcare Credentialing Specialist Growth & Compliance

Remote Jobs; Austin (TX); Vor Ort; USD 52.000 - 76.000; Vollzeit

Zusammenfassung

Sendero is seeking a Credentialing Specialist to manage credentialing and re-credentialing for all providers. The role supports growth through compliant provider data, primary source verifications, and collaboration with multiple departments.

In a startup-like, fast-paced nonprofit health plan, you will help implement new credentialing software and ensure adherence to TDI, NCQA, and CMS standards while maintaining high data quality.

Qualifikationen

• Requires High School Diploma or equivalent (higher degree accepted).
• Minimum 2 years credentialing experience in a healthcare setting.
• Strong understanding of credentialing and re-credentialing processes, including provider applications and licensure verification.
• Proficient with credentialing software and standard office tools.
• Ability to manage competing priorities and maintain compliance with regulatory standards.

Aufgaben

• Coordinate and maintain credentialing and re-credentialing for all providers, including ancillary and facility providers.
• Process, update and maintain provider files and load data into credentialing database.
• Obtain primary source verification of education, licensure, work experience, and other qualifications.
• Ensure compliance with regulatory standards (TDI, NCQA, CMS, etc.).
• Assist with regulatory audits and documentation preparation.
• Participate in implementation and conversion of new credentialing software.
• Develop configuration standards and best practices for credentialing systems.
• Support the network team with credentialing tasks and provider management.
• Perform other duties as assigned by management.

Kenntnisse

Adapt to change

Microsoft Office

Detail-oriented

Independent worker

Team collaboration

Communication

Ausbildung

High School Diploma or equivalent

Tools

Credentialing software

Microsoft Office

Adobe

Jobbeschreibung

Sendero is seeking a Credentialing Specialist to manage credentialing and re-credentialing for all providers. The role supports growth through compliant provider data, primary source verifications, and collaboration with multiple departments.

In a startup-like, fast-paced nonprofit health plan, you will help implement new credentialing software and ensure adherence to TDI, NCQA, and CMS standards while maintaining high data quality.