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Insurance Credentialing Jobs in Texas (NOW HIRING)

Emergicon LLC

Credentialing Specialist

Terrell, TX

$23 - $25/hr

The Credentialing & Reimbursement Specialist is responsible for coordinating, monitoring, and ... insurance addresses Prepare enrollment applications for all health plans, including Medicare and ...

PDS Health

Temporary 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 ...

Emergicon LLC

Credentialing Specialist

Terrell, TX · On-site

$23 - $25/hr

The Credentialing & Reimbursement Specialist is responsible for coordinating, monitoring, and ... and insurance addresses • Prepare enrollment applications for all health plans, including ...

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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.
Credentialing Specialist

Credentialing Specialist

Townsen Memorial Hospital

Humble, TX

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 8 days ago

Job description

Townsen Memorial is hiring a Full-Time Credentialing Specialist at our Humble Location!
The Credentialing Specialist is responsible for leading, coordinating, monitoring, and maintaining the credentialing and re-credentialing process.
ESSENTIAL FUNCTIONS:
• Compiles and maintains current and accurate data for all providers
• Completes provider credentialing and re-credentialing applications monitors applications and follows-up as needed
• Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
• Maintains corporate provider contract files
• Maintains knowledge of current credentialing processes for al providers
• Sets up and maintains provider information in online credentialing databases and systems
• Tracks licenses and certification expirations for all providers to ensure timely renewals
• Processes applications for appointment and reappointment of privileges to the facility
• Maintains facility appointment files, and information in credentialing database
• Identifies issues that require additional investigation and evaluation, validates discrepancies and ensures appropriate follow up
• Ensures compliance with Medical Staff Bylaws, rules and regulations, policy and procedures
• Assists with credentialing audits
• Performs other related duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES:
• Knowledge and understanding of credentialing process
• Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources
• Ability to organize and prioritize work and manage multiple priorities
• Excellent attention to detail, verbal and written communication skills including letters, memos, and emails
• Ability to maintain positive, constructive, collaborative, cooperative professional friendly and respectful working relationship with coworkers and supervisor
• Ability to research and analyze data
• Ability to work independently with minimal supervision
• Ability to establish and maintain effective working relationships with providers, management, staff and contacts outside the organization
EDUCATION AND EXPERIENCE:
•High school diploma or GED
•Basic Life Support (BLS) certified or must be obtained within thirty (30) days of hire
BENEFITS:
3 Medical Plans
2 Dental Plans
1 Vision Plan
Employee Assistance Program
Short and Long-Term Disability Insurance
Basic and Voluntary Life with AD amp;D Plan
401(k) with a 2-year vesting
PTO + Holidays
Townsen Memorial Hospital is an accredited network of facilities with an emphasis on emergency care, outpatient surgery, and diagnostics and imaging. Our core mission is to provide compassionate, evidence-based patient care to those we serve. At Townsen Memorial, we encompass diversity, dignity, and inclusiveness as a reflection of our core values. Townsen Memorial is committed to driving cutting edge healthcare to our patients, our communities and each other.
Compensation to be determined by the education, experience, knowledge, skills, and abilities of the applicant, internal equity, and alignment with market data.
Employment for this position is contingent upon the successful completion of a background check and drug screening.

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