Remote Provider Credentialing Jobs in Houston, TX

About Cedar Gate Technologies

Cedar Gate Technologies, an IQVIA business, enables payers, providers, employers, and service administrators to excel at value-based care with a unified technology and services platform delivering analytics, care, and payment technology on a single data management foundation. At Cedar Gate, you'll be part of a collaborative, innovative environment where great ideas thrive. We invest deeply in our people through ongoing training, comprehensive benefits, and a strong culture of teamwork, offering the chance to grow your skills while contributing to high impact initiatives for some of the world's most dynamic companies.

Position Summary

As a Client Services Representative, Credentialing at Cedar Gate Technologies, an IQVIA business, you will play a key role in supporting credentialing services for healthcare clients by maintaining accurate provider information, validating data, and resolving credentialing-related discrepancies. Serving as a trusted resource to physician practices, hospitals, and healthcare payers, you will apply your knowledge of provider credentialing processes, industry regulations, and established policies to ensure the integrity and quality of credentialing data.

In this fast-paced environment, you will manage multiple priorities while meeting time-sensitive deadlines with exceptional attention to detail and accuracy. You will use sound judgment to research and resolve issues, adapt to evolving client and business needs, and contribute to the successful delivery of high-quality credentialing services. Strong organizational and customer service skills are essential, as you will build productive client relationships, deliver responsive support, and help drive client satisfaction and operational excellence. Your ability to balance precision, responsiveness, and professionalism will make you a valued contributor to both the Credentialing team and Cedar Gate's continued success.

Roles & Responsibilities

• Prepare credentialing information for the client's contracted health plans, including document review and credentialing file preparation
• Perform primary source verifications
• Follow up with individual practitioners and internal and external entities to resolve discrepancies identified during the credentialing process
• Keep the manager informed of potential credentialing issues or delays
• Complete data entry of provider credentialing information into web-based provider database
• Maintain an accurate database of provider credentialing information in a web-based provider database by performing routine data reconciliation
• Prepare credentialing committee meeting documents for distribution, facilitate committee meetings and record meeting minutes
• Complete review of scanned provider file documents in OnBase to validate document retention
• Prepare and review provider application and client documents for annual payer audits
• Communicate with client's payers to ensure timely receipt of provider payer effective dates
• Participate in annual policies and procedures review and revision
• File and maintain credentialing contract file documents
• Maintain a working knowledge & application of computer directories, folders, and worksheets for filing and storing data
• Respond to all practitioners, client health plans, and internal inquiries in a timely manner
• Participate in team meetings and process improvement initiatives to continuously improve work product quality and efficiency

Job Location

Houston, TX, highly preferred - Hybrid (1 day in office, 4 remote);

May also consider anywhere in the United States

U.S. residents only; work must be performed within the United States.

Experience / Qualifications

• 3+ years of credentialing experience, preferably in a delegated credentialing environment
• NAMSS Certified Provider Credentialing Specialist (CPCS) certification preferred or working toward certification
• Detail-oriented with the ability to recognize vital information from credentialing documents
• Proven ability to exercise independent judgment in managing and relaying confidential information
• Ability to work well under tight deadlines and respond to changing demands and provide efficient follow-up rapidly
• Ability to consistently meet or exceed quality and production expectations
• Proficiency in data entry and use of databases and other credentialing related databases
• Professional experiences with problem-solving, critical thinking, and deductive reasoning skills
• Outstanding oral, written, and interpersonal communication skills
• Excellent customer service skills
• To be eligible for this position, you must reside in the same country where the job is located.

IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. Learn more athttps://jobs.iqvia.com

IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. https://jobs.iqvia.com/eoe

IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism.