Senior Credentialing Specialist – Hybrid

. Coordinate all activities associated with credentialing and re-credentialing of physicians and providers .

Posted 9/25/2026full-timeHouston • Texas • United StatesSeniorWebsite

Tools & technologies

Spring

Key responsibilities & impact

Coordinate all activities associated with credentialing and re-credentialing of physicians and providers
Ensure credentialing policies and procedures meet organizational, state regulatory, and external accreditation requirements
Implement and monitor procedures related to credentialing, re-credentialing, and privileging of network providers
Process provider applications and re-applications, including initial mailing, review, and database loading
Lead training initiatives for less experienced specialists
Participate in proctoring credentialing exams
Conduct regular file audits
Maintain the provider profiling system
Communicate with providers by phone and mail regarding credentialing status
Provide guidance or expertise to less experienced specialists
Serve as a liaison during credentialing processes
Assist in managing credentialing policies, procedures, and provider delegation maintenance
Ensure compliance with Memorial Hermann policies, procedures, standards, budgetary specifications, time management, supply management, productivity, and quality of service
Support department-based goals and serve as a preceptor, mentor, and resource to less experienced staff
Model Memorial Hermann service standards and provide safe, caring, personalized, and efficient experiences
Perform other duties as assigned

What you’ll need

Must be local to Houston or surrounding areas
Three (3) years of credentialing experience in a managed care plan, Medical Staff Services, or credentialing verification office
Advanced knowledge in payer enrollment, including Medicare and Medicaid enrollment (highly preferred)
Knowledge of CAQH/Data Spring, CMS, TMHP enrollment, Medicare enrollment, and PECOS portal (highly preferred)
Strong analytical skills, including assessing compliance and recording, analyzing, and interpreting data
Effective oral and written communication skills
Basic computer skills, including Microsoft Office, Word, and Excel
Proficient understanding of Joint Commission, NCQA, and URAC accreditation standards
Demonstrated understanding of initial credentialing and re-credentialing practices for medical professionals
Knowledge of primary source verification methods and compliance monitoring
Associate degree preferred
Licenses/certifications: None

Comp & perks