• Provider Credentialing Specialist

    AccentCare, Inc. (TX)


    Overview

     

    Provider Credentialing Specialist

     

    Position: Credentialing Specialist

     

    Position Type: Full-Time

     

    Remote/Virtual Position: Yes

     

    Find Your Passion and Purpose as a Provider Credentialing Specialist

     

    Salary: $23.00/hr to $26.00/hr DOE

     

    What You Need to Know

     

    Reimagining Your Career in Corporate Healthcare

     

    Caring for others is more than what you do — it’s who you are. At AccentCare, you’ll join a purpose-driven, collaborative culture that sets the standard for excellence and gives you the trust and tools to do your best work. You’ll belong to a team that cares deeply for patients and each other; a team committed to consistently providing exceptional care.

     

    We’re proud to be named one of America’s Greatest Workplaces 2025 by Newsweek — a reflection of our shared commitment to excellence, integrity and compassion as we shape the future of aging in place. When you thrive, so does the community of care we’re building together.

     

    Be the Best Provider Credentialing Specialist You Can Be

     

    If you meet these qualifications, we want to meet you!

     

    + Associates Degree

    + 2+ years of relevant credentialing experience within healthcare required

    + Medicaid/Medicare PECOS enrollment experience required

    + Availity experience preferred

    + Ability to organize and prioritize work and manage multiple priorities

    + Ability to research and analyze data

    + Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization

    Responsibilities:

    As a Provider Credentialing Specialist, you will be responsible for ensuring credentialing files are complete and current by gathering, tracking, and completing new and re-credentialing applications of our medical providers with health plans, including Medicare/Medicaid and Commercial .

     

    + Process contract payments. Manage allocation of group payments. Test and transition manual processes to automated system in HRIS software

    + Weekly/Bi-weekly reconciliation of group timecards. Assess new contracts and contract amendments and make necessary adjustments in applicable software systems

    + Maintain internal provider grid to ensure information is kept accurate and available

    + Maintain close working relationship with Billing and Authorizations Departments to identify and resolve denials and/or authorization issues related to provider credentialing

    + Manage, process and complete requests for; Validation and re-validation issued by government and commercial payer, Credentialing and re-credentialing for commercial payers, Medicare and Medicaid

    + Maintain and update to ensure accurate provider profiles on various databases, including, but not limited to; Council for Affordable Quality Healthcare (CAQH), Provider Enrollment, Chain and Ownership System (PECOS) for Medicare, National Plan and Provider Enumeration System (NPPES), Centers for Medicare & Medicaid Services (CMS)

    + Communicates clearly with providers and/or their liaisons, as needed to provide timely responses upon request on day-to-day credentialing and privileging issues as they arise.

    + Will need to maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certifications.

     

    Our Investment in You

     

    Caring for others starts with caring for you. We’re committed to fostering a purpose-driven workplace where you feel supported, and that means prioritizing your physical, financial and mental well-being. Our benefits include:

     

    + Medical, dental, and vision coverage

    + Paid time off and paid holidays

    + Professional development opportunities

    + Company-matching 401(k)

    + Flexible spending and health savings accounts

    + Wellness offerings such as an employee assistance program, pet insurance, and access to Calm, a meditation, sleep, and relaxation app

    + Programs to celebrate achievements, milestones, and fellow employees

    Qualifications

    Come As You Are

    At AccentCare, our care is most compassionate when we empathize and engage with everyone, and we are at our best when we value diverse perspectives, foster open dialogue, and enact change. And we are stronger when each of us is empowered to grow, be our unique selves, and feel a sense of inclusion and belonging.

     

    AccentCare is proud of how we are building a culture and inclusive infrastructure to help elevate the voice of all our employees with a special focus on the underrepresented and marginalized. We offer equal employment opportunities regardless of a person’s race, ethnicity, sex, sexual orientation, gender identity or expression, religion, national origin, color, creed, age, mental disability, physical disability, or any other protected classification.