Credentialing Specialist

We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health®, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. Location: Farmers Branch Office, 4055 Valley View Lane, Dallas, TX Work Arrangement: Hybrid preferred for candidates located within 40 miles of the Dallas-Fort Worth office, with an expectation to work onsite at least once per month. Fully remote consideration is available for candidates outside the local area. Will consider candidates across the US, however work schedule would align to central time zone. Position Summary The Credentialing Specialist ensures clinicians successfully pass the Signify Health credentialing process. This role is responsible for assisting clinicians with the completion of their credentialing applications, performing primary source verifications, and maintaining the MD Staff credentialing database. The Specialist must ensure all credentialing functions comply with internal policies, client health plan contracts, URAC guidelines, NCQA standards, and applicable state and federal requirements. This position reports to the Credentialing Supervisor. Key Responsibilities Review and process credentialing and re-credentialing files. Establish and maintain a system for the timely processing of credentialing files in accordance with NCQA policies. Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA standards. Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers. Review all background checks, drug tests, and TB screenings and record the results. Assemble all verified information and prepare files for presentation to the Credentialing Committee. Verify providers' requirements for approval to work in specific states and plans. Assist with the ongoing monitoring of contracted clinicians. Utilize the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency. Provide administrative support to department leadership and both internal and external stakeholders. Maintain professionalism at all times and provide timely, professional responses to all emails. Actively demonstrate teamwork and assist with special projects. Responsible for the security and privacy of any protected health information (PHI) accessed during work activities. Required Qualifications 1-3 years of successful work experience in a credentialing role/department. Intermediate skills with Google Suites. Must be familiar with NCQA accreditation standards. Demonstrate active listening skills and the ability to provide and receive constructive feedback. Strong interpersonal skills, with the ability to build rapport and productive relationships with internal and external stakeholders. Preferred Qualifications Obtain NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify. Working knowledge of problem-solving and decision-making skills. Ability to organize and prioritize workload and day-to-day tasks. Education High school diploma or up to 1 year of equivalent experience. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $17.00 - $28.46 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full-time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well-being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 11/30/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Our Work Experience Our Work Experience is the combination of everything that's unique about us: our culture, our core values, our company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They make choices according to what is best for the team, they live for opportunities to collaborate and make a difference, and they make us the #1 Top Workplace in the area. #J-18808-Ljbffr CVS Health