Credentialing and Enrollment Specialist
On-site · Houston, Texas, United States
Houston, Texas, United StatesOn-siteFull TimeMid LevelHigh School Or EquivalentUnknown
Type
Full Time
Level
Mid Level
Education
High School Or Equivalent
Company size
Unknown
Job Summary
Credentialing and Enrollment Specialist focused on end-to-end provider credentialing and enrollment using the Medallion platform, coordinating enrollment applications with Medicare/Medicaid and private payers, maintaining accurate provider records, tracking status, ensuring regulatory compliance, verifying credentials, preparing credentialing packets, and collaborating with billing, compliance, and HR to ensure timely, audit-ready credentialing and enrollment processes.
Required Qualifications
- High school diploma or equivalent
- 2+ years of experience in provider credentialing and enrollment
- Hands-on experience with the Medallion credentialing platform (strongly preferred)
- Knowledge of payer enrollment processes, CAQH, and healthcare regulations
- Familiarity with Medicare, Medicaid, and commercial insurance requirements
- Strong attention to detail and organizational skills
- Excellent communication and follow-up skills
- Ability to manage multiple tasks and meet deadlines
Desired Qualifications
- Certification such as CPCS (Certified Provider Credentialing Specialist) or CPMSM
- Experience working in a healthcare organization, medical group, or managed care environment
- Experience with credentialing audits and compliance standards (e.g., NCQA, Joint Commission)
- Strong attention to detail and organizational skills
- Excellent communication and follow-up skills
- Ability to manage multiple tasks and meet deadlines
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