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Insurance Credentialing Jobs in Texas (NOW HIRING)

Su Clinica

REVENUE CYCLE DIRECTOR

Harlingen, TX · On-site

Provides direct management of the Insurance Credentialing Department, Value Based Care Department, Billing Supervisor, and the Third-Party Billing and Collections Supervisor. All interaction with the ...

OneOncology

Credentialing Coordinator

Fort Worth, TX · On-site

Benefits: 401(k) AD&D insurance Dental insurance Disability insurance Flexible spending account Free parking Health insurance Life insurance Paid time off Vision insurance Experience: Credentialing ...

PDS Health

Coordinator, Credentialing

Irving, TX · On-site

$17 - $22.20/hr

Overview As a Credentialing Administrator at PDS Health you will be coordinating credentials for Dentists with various dental insurance carriers. Being a part of the Contracts Department which is ...

PDS Health

Coordinator, Credentialing

Irving, TX · On-site

$17/hr

As a Credentialing Administrator at PDS Health you will be coordinating credentials for Dentists with various dental insurance carriers. Being a part of the Contracts Department which is responsible ...

St. Louis Arc

Credentialing Specialist

Austin, TX · On-site

Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term ... Meets the standards as set forth in the Credentialing Policies and Procedures and NCQA compliance.

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Insurance Credentialing information

What does an insurance credentialing specialist do?

An insurance credentialing specialist is responsible for verifying healthcare providers' qualifications and obtaining necessary insurance network approvals. They manage provider enrollment, maintain accurate documentation, and ensure compliance with insurance company requirements, often using credentialing software. This role requires attention to detail and knowledge of insurance policies and provider credentialing processes.

What are the key skills and qualifications needed to thrive in Insurance Credentialing, and why are they important?

To thrive in Insurance Credentialing, you need strong attention to detail, knowledge of healthcare regulations, and experience with provider enrollment processes, often supported by a background in healthcare administration. Familiarity with credentialing software, CAQH ProView, and payer-specific portals is typically required, along with an understanding of HIPAA compliance. Excellent organizational skills, problem-solving abilities, and effective communication help professionals efficiently manage documentation and interact with providers and insurers. These skills are crucial to ensure timely provider enrollment, minimize claim denials, and maintain compliance with industry standards.

How much does a credentialing assistant make?

A credentialing assistant typically earns between $35,000 and $50,000 annually, depending on experience, location, and the size of the organization. They often work in healthcare or insurance settings, requiring attention to detail and familiarity with credentialing software and processes.

Is it hard to become a credentialing specialist?

Becoming a credentialing specialist typically requires attention to detail, knowledge of insurance processes, and familiarity with credentialing software. While some roles may require specific certifications or experience, the entry process is generally accessible with relevant administrative skills and training.

What degree do you need to be a credentialing specialist?

A credentialing specialist typically needs at least a high school diploma or equivalent; however, many employers prefer candidates with an associate's or bachelor's degree in healthcare administration, business, or a related field. Relevant skills include attention to detail, knowledge of healthcare regulations, and experience with credentialing software or databases.

What is insurance credentialing?

Insurance credentialing is the process by which healthcare providers and organizations are evaluated and approved by insurance companies to participate in their networks. This involves verifying the provider’s qualifications, licenses, education, and professional history to ensure they meet the insurer’s standards. Once credentialed, providers can bill the insurance company for services rendered to insured patients. The process can be time-consuming and requires submitting detailed documentation, but it is essential for providers who wish to accept insurance and expand their patient base.

What are some common challenges faced in the insurance credentialing process, and how can professionals effectively manage them?

Professionals in insurance credentialing often encounter challenges such as navigating complex and varying requirements from different insurance payers, managing frequent follow-ups, and ensuring all documentation is accurate and up-to-date. Staying organized and detail-oriented is essential, as missed deadlines or incomplete information can lead to delays in provider approvals. Using credentialing software, maintaining a well-structured tracking system, and fostering strong communication with both providers and insurers can help streamline the process and minimize setbacks.

What is the difference between Insurance Credentialing vs Medical Billing Specialist?

AspectInsurance CredentialingMedical Billing Specialist
Required CredentialsCertifications in healthcare administration, insurance, or related fieldsKnowledge of billing codes, insurance policies, and billing software
Work EnvironmentHealthcare provider offices, insurance companies, credentialing agenciesMedical offices, billing companies, healthcare facilities
Employer & Industry UsageHospitals, clinics, insurance payersMedical practices, billing firms, healthcare organizations
Common Search & ComparisonInsurance Credentialing vs Medical Billing Specialist

Insurance Credentialing involves verifying healthcare providers' qualifications with insurance companies to ensure they are eligible to accept insurance plans. Medical Billing Specialists handle the coding, submission, and follow-up of insurance claims for healthcare services. While both roles support healthcare reimbursement, credentialing focuses on provider eligibility, whereas billing centers on processing claims.

Insurance Credentialing jobs near you
Infographic showing various Insurance Credentialing job openings in Texas as of June 2026, with employment types broken down into 74% Full Time, 19% Part Time, 1% Temporary, and 6% Contract. Highlights an 93% Physical, 3% Hybrid, and 4% Remote job distribution.
Enrollment & Credentialing Specialist

Enrollment & Credentialing Specialist

ARBOR DIAGNOSTICS INC

Dallas, TX • On-site

Full-time

Medical, Retirement, PTO

Posted 15 days ago

Job description

Company Overview

Arbor is a leading laboratory specializing in diagnostic testing and healthcare services. We are committed to delivering accurate, timely results while ensuring seamless integration with insurance providers to support patient care and operational efficiency.

Position Summary

The Enrollment & Credentialing Specialist will play a critical role in the laboratory's revenue cycle management by facilitating the onboarding and credentialing of new insurance plans. This position involves coordinating with insurance companies, internal teams, and regulatory bodies to ensure compliance, timely enrollment, and smooth integration of new payers. The ideal candidate is detail-oriented, highly organized, and experienced in healthcare administration, with a focus on insurance credentialing processes.

Key Responsibilities

  • Insurance Onboarding and Credentialing: Lead the end-to-end process of onboarding new insurance plans, including application submission, documentation gathering, and follow-up to secure approvals and contracts.
  • Compliance and Regulatory Adherence: Ensure all credentialing activities comply with federal, state, and insurance-specific regulations (e.g., CAQH, PECOS, HIPAA). Monitor changes in payer requirements and update internal protocols accordingly.
  • Documentation Management: Collect, review, and maintain accurate provider credentials, licenses, certifications, and other required documents for lab physicians, technicians, and the facility.
  • Collaboration and Communication: Work closely with billing, finance, legal, and clinical teams to resolve credentialing issues. Serve as the primary point of contact for insurance representatives during the onboarding phase.
  • Process Improvement: Identify opportunities to streamline onboarding workflows, reduce turnaround times, and implement best practices to enhance efficiency.
  • Tracking and Reporting: Maintain detailed records of credentialing status using tracking systems or databases. Generate reports on onboarding progress, timelines, and potential bottlenecks for management review.
  • Re-credentialing Support: Assist with periodic re-credentialing of existing insurance plans to maintain active status and prevent disruptions in billing.
  • Issue Resolution: Investigate and resolve denials or delays related to credentialing, collaborating with payers to expedite resolutions.

What We Offer

  • Competitive salary and benefits package, including health insurance, retirement plans, and paid time off.
  • Opportunities for professional development and certification reimbursement.
  • A collaborative work environment focused on innovation and patient-centered care.

Arbor is an equal opportunity employer. We encourage applications from diverse candidates. To apply, please submit your resume and cover letter to [email address] or visit our careers page.

This job description is intended to convey information essential to understanding the scope of the position and is not exhaustive. Duties and responsibilities may evolve as needed.

Qualifications

  • Education: Bachelor's degree in Healthcare Administration, Business Administration, or a related field. Relevant certifications (e.g., CPCS - Certified Provider Credentialing Specialist) are highly preferred.
  • Experience: Minimum of 2-3 years in healthcare credentialing, payer enrollment, or revenue cycle management, preferably in a laboratory or medical setting. Experience with insurance onboarding for diagnostic labs is a plus.
  • Skills:
    • Strong knowledge of insurance credentialing processes, including applications for Medicare, Medicaid, and commercial payers.
    • Proficiency in credentialing software (e.g., CAQH ProView, Credential Stream) and Microsoft Office Suite (Excel, Word, Outlook).
    • Excellent organizational and multitasking abilities, with a keen eye for detail.
    • Superior communication skills, both written and verbal, for interacting with internal stakeholders and external partners.
    • Ability to work independently in a fast-paced environment while meeting strict deadlines.
  • Other Requirements: Familiarity with healthcare regulations and privacy laws. Must be able to handle confidential information with discretion.

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