Credentialing Specialist

CVS Health Careers

. Review and process credentialing and re-credentialing files .

Posted 10/30/2026full-timeFarmers Branch • Texas • United StatesJunior💰 $17 - $28 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in credentialing processes, including compliance with NCQA standards and management of provider documentation. Proficient in utilizing credentialing databases and providing administrative support while maintaining confidentiality of protected health information.

Highest-signal resume keywords

Credentialing ExperienceNCQA Accreditation StandardsMD Staff Credentialing DatabaseActive Listening SkillsInterpersonal Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingDocument ManagementBackground ChecksDrug TestingTB ScreeningsReport GenerationGoogle SuitesProvider ComplianceFile PreparationTimely Processing

Soft Skills

TeamworkConstructive FeedbackOrganizational SkillsPrioritizationRelationship Building

Tools & Technologies

MD Staff Credentialing Database

Certifications & Qualifications

Certified Provider Credentialing Specialist (CPCS)

Industry Keywords

CredentialingNCQA PoliciesProtected Health Information (PHI)State LicensesDEA CertificatesMalpractice Coverage

About the role

Key responsibilities & impact

Review and process credentialing and re-credentialing files
Establish and maintain a system for timely processing of credentialing files in accordance with NCQA policies
Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA standards
Maintain current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for providers
Review background checks, drug tests, and TB screenings and record results
Assemble verified information and prepare files for Credentialing Committee presentation
Verify providers’ requirements for approval to work in specific states and health plans
Assist with ongoing monitoring of contracted clinicians
Use the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency
Provide administrative support to department leadership and internal and external stakeholders
Provide timely, professional email responses
Demonstrate teamwork and assist with special projects
Protect the security and privacy of protected health information (PHI)
Report to the Credentialing Supervisor

Requirements

What you’ll need

1-3 years of successful work experience in a credentialing role/department
Intermediate skills with Google Suites
Familiarity with NCQA accreditation standards
Active listening skills and ability to provide and receive constructive feedback
Strong interpersonal skills and ability to build rapport and productive relationships with internal and external stakeholders
High school diploma or up to 1 year of equivalent experience
Preferred: Obtain NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify
Preferred: Working knowledge of problem-solving and decision-making skills
Preferred: Ability to organize and prioritize workload and day-to-day tasks
Work schedule aligned to Central Time Zone

Benefits

Comp & perks

Medical coverage
Dental coverage
Vision coverage
Paid time off
Retirement savings options
Wellness programs
Other resources supporting physical, emotional, and financial well-being
CVS Health bonus, commission or short-term incentive program in addition to base pay