Credentialing Specialist

Schedule: Monday through Friday either 8am-5pm or 9am-6pm Pay Rate: $20-$22/hr (depending on experience) REQUIREMENT: Bilingual English/Spanish preferred Location: Hybrid Remote/In-Clinic or Fully Remote Clinic Location: 16835 Deer Creek Drive, Spring, TX 77379 Company Website: Job Description: Clinical Specialist The Credentialing Specialist is responsible for managing the credentialing and re-credentialing process for licensed therapists — including Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), and Physical Therapists (PTs) — ensuring compliance with regulatory, accreditation, and organizational standards. This role verifies provider qualifications, licenses, certifications, and work history to support patient safety, risk management, and payer enrollment requirements. Key Responsibilities Process initial credentialing and re-credentialing applications for speech, occupational, and physical therapists Perform primary source verification of state licenses, national certifications (e.g., ASHA CCC-SLP, NBCOT, NPTE), education, clinical training, malpractice history, and work references Maintain accurate and up-to-date provider files in credentialing software/databases (e.g., CAQH, Symplr, MD-Staff) Track and manage expiration dates for licenses, certifications, CEUs, and liability insurance coverage; proactively initiate renewal processes Coordinate with clinical operations, insurance payers, and facility/agency partners to complete enrollment and privileging Ensure compliance with NCQA, URAC, Joint Commission, CMS, state licensing boards, and payer-specific requirements Prepare credentialing files and reports for internal review and audits Communicate with therapists to obtain missing documentation or clarify discrepancies Respond to inquiries from internal departments, payers, and external agencies regarding credentialing status Maintain confidentiality of sensitive provider information in accordance with HIPAA Assist with internal and external audits related to credentialing compliance Monitor state-specific licensure requirements across multiple jurisdictions if supporting multi-state practice or telehealth therapy services Required Qualifications High school diploma or equivalent required; associate or bachelor’s degree preferred 2+ years of experience in credentialing, healthcare administration, or a therapy/rehab services setting Familiarity with credentialing software and databases Strong understanding of credentialing standards (NCQA, URAC, Joint Commission) and therapy-specific licensure/certification bodies (state PT/OT/SLP boards, ASHA, NBCOT, FSBPT) Excellent organizational skills and high attention to detail Strong written and verbal communication skills Ability to manage multiple priorities and meet deadlines Proficiency in Microsoft Office (Excel, Word, Outlook) Preferred Qualifications Certified Provider Credentialing Specialist (CPCS) certification Experience with payer enrollment processes for rehab/therapy services Experience credentialing across multiple states (for multi-state or telehealth practices) Knowledge of HIPAA and healthcare compliance regulations Work Environment Office-based, hybrid, or fully remote depending on organization May require occasional overtime during audit periods or high-volume credentialing cycles #J-18808-Ljbffr