Hybrid Credentialing Specialist — Provider Enrollment Expert

Memorial Hermann Health System; United States; Hybrid; USD 65,000 - 95,000; Full time

Job summary

Memorial Hermann Health System in Houston is seeking a Senior Credentialing Specialist to coordinate credentialing and re-credentialing for physicians and providers.

The role requires payer enrollment expertise (Medicare/Medicaid, CAQH, PECOS), strong data analysis, and liaison with providers to maintain compliance with Joint Commission, NCQA, and URAC standards. Hybrid schedule with in-office and remote weeks.

Qualifications

• Associates degree preferred.
• Three years of credentialing experience in managed care, medical staff services, or credentialing verification.
• Strong analytical skills to assess compliance and interpret data.
• Excellent oral and written communication; proficient with MS Office.
• Understanding of Joint Commission, NCQA, and URAC accreditation.

Responsibilities

• Coordinate credentialing and re-credentialing of physicians and providers.
• Process applications and re-applications; load data into systems with high quality.
• Lead training for less experienced specialists and perform file audits.
• Maintain provider profiling and communicate credentialing status with providers.
• Serve as liaison to providers and ensure timely credentialing information.

Skills

Payer enrollment

CAQH enrollment

CMS enrollment

Medicare enrollment

PECOS portal

Analytical skills

Oral and written communication

Microsoft Office

Primary source verification

Joint Commission / NCQA / URAC

Education

Associates degree preferred

Tools

Microsoft Office

Excel

Job description

Memorial Hermann Health System in Houston is seeking a Senior Credentialing Specialist to coordinate credentialing and re-credentialing for physicians and providers.

The role requires payer enrollment expertise (Medicare/Medicaid, CAQH, PECOS), strong data analysis, and liaison with providers to maintain compliance with Joint Commission, NCQA, and URAC standards. Hybrid schedule with in-office and remote weeks.