ZipRecruiter

Log In

1

Insurance Credentialing Jobs in Texas (NOW HIRING)

Evette

Senior Credentialing Manager

Dallas, TX · Remote

... PLIT insurance, and work history • Ensure compliance with federal, state, and DVM requirements • Maintain complete, accurate, and audit-ready credentialing files • Develop and maintain ...

Driscoll

CME - Credentialing Spec

Corpus Christi, TX

She will also assist with credentialing commercial insurance carriers for all providers within CPSST practicing. Duties include but are not limited to ensuring accurate and timely update of addresses ...

Prevail Counseling

Psychologist

Conroe, TX · On-site

$85K - $90K/yr

We handle all insurance credentialing directly in-house, completely independent of platforms like Headway or Alma. * Full Administrative Support: Our dedicated front and back office teams manage the ...

Prevail Counseling

Mental Health Counselor

Spring, TX · On-site

$45K - $60K/yr

We handle all insurance credentialing directly in-house, completely independent of platforms like Headway or Alma. * Full Administrative Support: Our dedicated front and back office teams manage the ...

Medix

Credentialing Specialist (Onsite)

Dallas, TX · On-site

$22 - $29/hr

Manage the credentialing process for oral surgeons and general dentists * Complete roster ... Term Life Insurance Plan. * We will consider for employment all qualified Applicants, including ...

next page

Showing results 1-20

All JobsInsurance Credentialing JobsInsurance Credentialing Jobs in Texas

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 and Enrollment Specialist

Senior PsychCare

Houston, TX

Other

Medical, Dental, Vision, Life, Retirement, PTO

Posted 22 days ago

Job description

Credentialing and Enrollment Specialist (Medallion Platform)- Houston, TX 77027
About Us:
Senior Psych Care provides fully integrative behavioral health services to the long-term care patient, at their facility.
Job Summary:
The Credentialing and Enrollment Specialist is responsible for managing provider credentialing, re-credentialing, and payer enrollment processes using the Medallion credentialing platform. This role ensures that healthcare providers are properly credentialed and enrolled with insurance networks in a timely and compliant manner.
Key Responsibilities:

  • Manage end-to-end provider credentialing and re-credentialing processes using the Medallion platform
  • Coordinate and process provider enrollment applications with commercial and government payers (e.g., Medicare, Medicaid, and private insurers)
  • Maintain accurate and up-to-date provider records within Medallion and internal systems
  • Track application status, follow up with payers, and resolve delays or discrepancies
  • Ensure compliance with regulatory standards, payer requirements, and organizational policies
  • Verify provider credentials including licenses, certifications, malpractice insurance, and work history
  • Prepare and submit credentialing packets and enrollment applications
  • Communicate with providers to obtain required documentation and updates
  • Monitor expiration dates and initiate recredentialing cycles proactively
  • Generate reports and maintain audit-ready documentation
  • Collaborate with internal departments such as billing, compliance, and HR
Required Qualifications:
  • High school diploma or equivalent (Associate's or Bachelor's degree preferred)
  • 2+ years of experience in provider credentialing and enrollment
  • Hands-on experience with the Medallion credentialing platform (strongly preferred)
  • Knowledge of payer enrollment processes, CAQH, and healthcare regulations
  • Familiarity with Medicare, Medicaid, and commercial insurance requirements
  • Strong attention to detail and organizational skills
  • Excellent communication and follow-up skills
  • Ability to manage multiple tasks and meet deadlines
Preferred Qualifications:
  • Certification such as CPCS (Certified Provider Credentialing Specialist) or CPMSM
  • Experience working in a healthcare organization, medical group, or managed care environment
  • Experience with credentialing audits and compliance standards (e.g., NCQA, Joint Commission)
Key Skills:
  • Proficiency in Medallion platform and credentialing tools
  • Data entry and record management accuracy
  • Problem-solving and issue resolution
  • Time management and prioritization
  • Customer service and provider relations
Work Environment:
  • Office-based
  • Fast-paced healthcare administrative setting
  • Job Summary:
    The Credentialing and Enrollment Specialist is responsible for managing provider credentialing, recredentialing, and payer enrollment processes using the Medallion credentialing platform. This role ensures that healthcare providers are properly credentialed and enrolled with insurance networks in a timely and compliant manner.

What We Offer:
  • Competitive salary, commensurate with experience
  • Comprehensive benefits package including:
  • Medical
  • Dental
  • Vision
  • Short and Long Term Disability
  • Life Insurance
  • 401 (k)
  • Paid Time Off and Paid Holidays

Apply