Job Description

Position: Senior Credentialing Specialist

Location: Houston, TX (5 days onsite)

Duration: 12 Months

Job Description:

We are seeking an experienced Senior Credentialing Specialist with expertise in CVO (Credentials Verification Organization) operations, Provider Credentialing, and provider enrollment. The candidate will be responsible for managing the end-to-end credentialing lifecycle, including Primary Source Verification (PSV), regulatory compliance, provider onboarding, re-credentialing, and payer enrollment activities.

Key Requirements:

• 5 8 years of experience in provider credentialing and CVO operations.
• Strong experience in PSV, CAQH, provider enrolment, and re-credentialing.
• Knowledge of NCQA, CMS, Joint Commission, OIG, and SAM compliance requirements.
• Experience verifying provider licenses, education, certifications, work history, malpractice coverage, and sanctions screening
• Hands-on experience with credentialing platforms
• Ability to manage credentialing files, support committee reviews, maintain provider data, and ensure SLA adherence

Preferred Background: Candidates from healthcare payers, hospitals, health systems, managed care organizations, or credentialing service providers with relevant certifications (CPCS, CPMSM) are highly preferred

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