Rose International
NEW JOB OPENING CREDENTIALING COORDINATOR IN FARMERS BRANCH, TX, USA!
Rose International, Texas City, Texas, us, 77592
Job Description
Required Education:
• High School Diploma.
Preferred Education: • Associate's degree.
Preferred License: • Preferred NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS)
Required Qualifications/Skills/Experience: • Ability to verify licensure and education • Experience filling out applications • Strong attention to detail and admin skills
Preferred Experience: • 1-3 years, Credentialing or licensure experience highly preferred • Preferred CAQH Experience, preferred MD Staff Experience, preferred Goggle Suites Experience and highly preferred Licensure Experience.
Compliance: • Candidate will have access to PHI (Personal Health Information) • Drug test required due to data sensitivity
[Credentialing Coordinator] Overview: • The Credentialing Coordinator role will be responsible on ensuring compliance with NCQA, URAC, Medicare, Medicaid, Delegation agreements and other pertinent client requirements, policies and procedures, client health plan contracts, URAC guidelines and applicable state and federal requirements.
Job Duties: • Verifying State Licenses, exclusions lists, DEA's, Board Certifications and Medicaid/Medicare Enrollment Verifications on an ongoing basis to ensure qualified and approved clinicians remain active in the network. • Enrolling clinicians in Medicare and Medicaid following state and federal guidelines • Applying for state licensure for clinicians • S/He will maintain strong cross-departmental relationships with Recruiting, Production, and Education This role will report to our Supervisor of the Credentialing Hub. • Candidates will monitor files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate • Enters, updates, and maintains data from provider applications into the credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses and in accordance with internal policies and procedures • Prepares, issues, electronically tracks, and follows up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines • Communicates clearly with providers, internal/external clients, and all Client staff as needed to provide timely responses upon request on day-to-day credentialing issues as they arise • Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of the latest developments to enhance understanding of various regulations and legislation of the healthcare industry and assist with special projects on an as-needed basis
Industry: Healthcare Estimated Start Date: 09/29/2025
**Only those lawfully authorized to work in the designated country associated with the position will be considered.**
**Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**
Benefits: For information and details on employment benefits offered with this position, please visit here . Should you have any questions/concerns, please contact our HR Department via our secure website .
California Pay Equity: For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here .
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.
If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department .
Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).
Preferred Education: • Associate's degree.
Preferred License: • Preferred NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS)
Required Qualifications/Skills/Experience: • Ability to verify licensure and education • Experience filling out applications • Strong attention to detail and admin skills
Preferred Experience: • 1-3 years, Credentialing or licensure experience highly preferred • Preferred CAQH Experience, preferred MD Staff Experience, preferred Goggle Suites Experience and highly preferred Licensure Experience.
Compliance: • Candidate will have access to PHI (Personal Health Information) • Drug test required due to data sensitivity
[Credentialing Coordinator] Overview: • The Credentialing Coordinator role will be responsible on ensuring compliance with NCQA, URAC, Medicare, Medicaid, Delegation agreements and other pertinent client requirements, policies and procedures, client health plan contracts, URAC guidelines and applicable state and federal requirements.
Job Duties: • Verifying State Licenses, exclusions lists, DEA's, Board Certifications and Medicaid/Medicare Enrollment Verifications on an ongoing basis to ensure qualified and approved clinicians remain active in the network. • Enrolling clinicians in Medicare and Medicaid following state and federal guidelines • Applying for state licensure for clinicians • S/He will maintain strong cross-departmental relationships with Recruiting, Production, and Education This role will report to our Supervisor of the Credentialing Hub. • Candidates will monitor files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate • Enters, updates, and maintains data from provider applications into the credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses and in accordance with internal policies and procedures • Prepares, issues, electronically tracks, and follows up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines • Communicates clearly with providers, internal/external clients, and all Client staff as needed to provide timely responses upon request on day-to-day credentialing issues as they arise • Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of the latest developments to enhance understanding of various regulations and legislation of the healthcare industry and assist with special projects on an as-needed basis
Industry: Healthcare Estimated Start Date: 09/29/2025
**Only those lawfully authorized to work in the designated country associated with the position will be considered.**
**Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.**
Benefits: For information and details on employment benefits offered with this position, please visit here . Should you have any questions/concerns, please contact our HR Department via our secure website .
California Pay Equity: For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here .
Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.
If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department .
Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).