Senior Credentialing Specialist, TPR

Tenet Healthcare

. Work closely with the local market onboarding team on all new providers in the pipeline.

Posted 9/23/2026full-timeDallas • Texas • United StatesSeniorWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in credentialing processes, including CAQH applications and NCQA standards, while effectively managing relationships with health plans and ensuring compliance with payer requirements. Proven ability to identify process improvements and resolve billing issues in a deadline-driven environment.

Highest-signal resume keywords

Managed Care ExperienceCredentialing KnowledgeCAQH Application ProficiencyNCQA Standards FamiliarityProblem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

CredentialingData EntryFile MaintenanceContract Language InterpretationBilling ResolutionWorkflow Process ManagementPrimary Source VerificationHealth Plan EnrollmentOperational Procedures KnowledgeDeadline Management

Soft Skills

Customer Service SkillsVerbal CommunicationWritten CommunicationRelationship BuildingProblem-Solving

Tools & Technologies

Microsoft WordCredentialing DatabasesPC Applications

Industry Keywords

Health Care EnvironmentPayer CredentialingDelegated CredentialingCredentialing StandardsHealth Plan Submissions

About the role

Key responsibilities & impact

Work closely with the local market onboarding team on all new providers in the pipeline.
Request credentialing data and supporting documents from physicians.
Communicate physician-related delays that may jeopardize project timelines.
Prepare and/or update provider CAQH applications for newly affiliated and existing healthcare providers.
Communicate newly affiliated providers to health plans to initiate TIN changes, demographic flips, or credentialing.
Establish credentialed status to facilitate billing.
Maintain credentialing databases and up-to-date file process tracking.
Execute standard operating procedures and communicate issues, trends, and concerns to the Regional Supervisor.
Identify process improvement opportunities and work with the Regional Supervisor on payor-related challenges.
Complete workflow items within required turnaround times and quality expectations.
Resolve billing and collections issues for services rendered.
Educate internal markets on payor contractual obligations, authorizations, billing requirements, and operational procedures.
Provide credentialing information to Market Operations.
Perform data entry, initial credentialing or recredentialing per NCQA, health plan submissions, and UCC credentialing.

Requirements

What you’ll need

Minimum of five years of experience in a managed care role, centralized credentialing office or related health care environment, such as credentialing or file maintenance.
Knowledge of health plan and governmental payer credentialing, enrollment, and requirements.
Knowledge of CAQH application.
Knowledge of contract language interpretation and administration.
Ability to work within a deadline-intense environment.
Demonstrated problem-solving and customer service skills.
Knowledge of Microsoft Word and other PC applications.
High School Diploma required.
Excellent verbal and written communication skills.
Knowledge of NCQA standards, delegated credentialing, and Primary Source Verification.
Ability to build and maintain peer-to-peer relationships with relevant market Health Plans.
In-depth working knowledge of applications associated with health plans and workflow processes.