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Provider Credentialing Jobs in Texas (NOW HIRING)

ICONMA

Credentialing Coordinator

Farmers Branch, TX · On-site

Enters, updates, and maintains data from provider applications into the credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses and in ...

IntiGrow

Credentialing Coordinator

Farmers Branch, TX · On-site

$17 - $18/hr

Preferred NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) * Preferred CAQH Experience, preferred MD Staff Experience * Preferred Goggle Suites * Experience and highly ...

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All JobsProvider Credentialing JobsProvider Credentialing Jobs in Texas

Provider Credentialing information

See Texas salary details

$12

$22

$36

How much do provider credentialing jobs pay per hour?

As of Aug 9, 2026, the average hourly pay for provider credentialing in Texas is $22.69, according to ZipRecruiter salary data. Most workers in this role earn between $17.93 and $25.77 per hour, depending on experience, location, and employer.

What is provider credentialing?

Provider credentialing is the process by which healthcare organizations verify and assess the qualifications, experience, and professional background of medical providers, such as doctors, nurses, and specialists. This includes checking education, training, licenses, certifications, work history, and any malpractice or disciplinary actions. Credentialing ensures that providers meet the standards required to deliver care and are eligible for participation in health insurance networks. It is a critical step for patient safety and regulatory compliance. The process must be repeated periodically to maintain up-to-date records and ensure ongoing eligibility.

Is provider credentialing hard?

Provider credentialing can be a complex process that involves verifying a healthcare professional’s qualifications, licenses, and work history, often requiring attention to detail and organization. It typically involves working with multiple organizations and adhering to specific regulations, which can make the process time-consuming and challenging for some providers. Strong communication skills and familiarity with credentialing software can help streamline the process.

What does a provider credentialing specialist do?

A provider credentialing specialist is responsible for verifying healthcare providers' qualifications, licenses, and certifications to ensure they meet the standards required by insurance companies and healthcare organizations. They manage the credentialing process, maintain accurate provider records, and ensure compliance with regulatory requirements, often using specialized credentialing software. This role requires attention to detail, knowledge of healthcare regulations, and strong organizational skills.

How to get into provider credentialing?

To enter provider credentialing, candidates typically need a background in healthcare administration, medical billing, or related fields, along with strong organizational and communication skills. Gaining certification such as the Certified Provider Credentialing Specialist (CPCS) can enhance job prospects, and familiarity with credentialing software and industry standards is beneficial. Entry-level roles often require a high school diploma or equivalent, with some positions preferring an associate's or bachelor's degree.

What are some common challenges faced in a provider credentialing role, and how can they be managed?

A common challenge in Provider Credentialing is managing multiple deadlines and ensuring all documentation is accurate and up to date for various healthcare providers. The process often involves coordinating with providers, insurance companies, and regulatory bodies, which can lead to delays if communication is not clear. Staying organized, maintaining detailed records, and using credentialing management software can help streamline workflow and reduce errors. Building strong relationships with providers and team members also aids in resolving issues quickly and efficiently.

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

AspectProvider CredentialingMedical Billing Specialist
Required CredentialsLicenses, certifications, provider credentialsBilling certifications, coding knowledge
Work EnvironmentHealthcare facilities, insurance companiesMedical offices, billing companies
Employer & Industry UsageHospitals, clinics, insurance providersMedical practices, billing firms
Search & Comparison IntentUnderstanding credentialing process, requirementsBilling procedures, coding, reimbursement

Provider Credentialing focuses on verifying healthcare providers' qualifications to ensure they meet industry standards, while Medical Billing Specialists handle coding, billing, and reimbursement processes. Both roles are essential in healthcare operations but serve different functions within the industry.

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

To thrive in Provider Credentialing, you need strong attention to detail, organizational skills, and knowledge of healthcare regulations, typically supported by a background in healthcare administration or related fields. Familiarity with credentialing software, databases, and compliance tools such as CAQH ProView and state licensure systems is essential. Exceptional communication, problem-solving, and time management skills help professionals interact with providers and manage complex documentation processes. These competencies ensure accurate provider verification, regulatory compliance, and efficient onboarding, which are critical for healthcare organizations.
What are the most commonly searched types of Provider Credentialing jobs in Texas? The most popular types of Provider Credentialing jobs in Texas are:
What are popular job titles related to Provider Credentialing jobs in Texas? For Provider Credentialing jobs in Texas, the most frequently searched job titles are:
What job categories do people searching Provider Credentialing jobs in Texas look for? The top searched job categories for Provider Credentialing jobs in Texas are:
What cities in Texas are hiring for Provider Credentialing jobs? Cities in Texas with the most Provider Credentialing job openings:
Provider Credentialing jobs near you
Infographic showing various Provider Credentialing job openings in Texas as of June 2026, with employment types broken down into 1% Locum Tenens, 3% As Needed, 90% Full Time, 3% Part Time, and 3% Contract. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $47,202 per year, or $22.7 per hour.

Subject Matter Expert - Credentialing (State of Indiana)

Plutus Health

Addison, TX • Remote

Full-time

Re-posted 12 days ago

Job description

Role Summary

The Subject Matter Expert (SME) - Provider Credentialing (Indiana) serves as the authoritative resource for all credentialing, re-credentialing, and enrollment activities within the state of Indiana. This role provides strategic guidance, issue resolution, and subject expertise across Medicare, Indiana Medicaid, and commercial payers, ensuring regulatory compliance, payer alignment, and timely provider onboarding. The SME works closely with clients, internal teams, and offshore credentialing partners to address complex credentialing scenarios and optimize operational outcomes specific to Indiana.


Core Responsibilities

  • Act as the primary Subject Matter Expert for Indiana provider credentialing, including state-specific rules, timelines, and payer nuances
  • Provide expert guidance on initial credentialing, re-credentialing, and enrollment for Medicare, Indiana Medicaid (IHCP / Hoosier Healthwise, HIP, MCOs), and commercial payers
  • Serve as the escalation point for complex Indiana credentialing cases, denials, and payer delays
  • Interpret and apply Indiana-specific regulatory and payer requirements to ensure compliance and accuracy
  • Guide offshore and internal teams on Indiana Medicaid enrollment processes, including MCO credentialing workflows
  • Review provider applications and documentation for state-specific completeness and accuracy
  • Engage directly with Indiana payer enrollment departments to resolve issues and accelerate approvals
  • Ensure provider data accuracy across CAQH, PECOS, NPPES, and payer portals relevant to Indiana
  • Maintain oversight of credentialing trackers and dashboards with a focus on Indiana-based providers
  • Support internal and external audits, ensuring adherence to HIPAA and Indiana payer guidelines
  • Collaborate with sales and client success teams to provide Indiana credentialing expertise during onboarding and expansion
  • Contribute to process improvements, SOP development, and training materials related to Indiana credentialing


Indiana-Specific Expertise

  • In-depth knowledge of Indiana Health Coverage Programs (IHCP)
  • Experience with Hoosier Healthwise, Healthy Indiana Plan (HIP), CareSource, Anthem Indiana, Managed Health Services (MHS), UnitedHealthcare Community Plan Indiana
  • Familiarity with Indiana Family and Social Services Administration (FSSA) credentialing requirements
  • Understanding of Indiana Medicaid revalidation and enrollment timelines
  • Expertise in Indiana-specific payer escalation paths and common enrollment bottlenecks


Required Qualifications

  • 10+ years of U.S. provider credentialing experience, with deep hands-on expertise in Indiana credentialing
  • Strong working knowledge of Indiana Medicaid, Medicare, and commercial payer enrollment
  • Extensive experience using CAQH, PECOS, NPPES, and Indiana-relevant payer portals
  • Proven ability to resolve complex credentialing issues and guide teams through escalations
  • Excellent communication, documentation, and stakeholder management skills


Tools & Systems

  • CAQH, PECOS, NPPES
  • OIG, SAM, Indiana Medicaid Exclusion Lists
  • Medicare Opt-Out List
  • Social Security Death Master File (SSDMF)
  • Payer portals: Anthem Indiana, UHC Indiana, Cigna, Humana, Indiana Medicaid MCO portals
  • Credentialing dashboards and Excel-based trackers

Apply