Credentialing Analyst – Texas
Remote position – Candidate must reside in Texas.
The Credentialing Analyst supports the credentialing program and ensures practitioners and facilities meet federal, state, local, and NCQA accreditation requirements. The role involves provider credentialing, data management, audits, reporting, and communication with providers and internal teams.
Key Responsibilities:
- Manage and track provider credentialing applications and ongoing reviews.
- Maintain accurate provider and facility data for directories, billing, and member support.
- Analyze and report credentialing data using external database portals.
- Support delegated and non-delegated provider audits.
- Identify process improvements and provide recommendations.
- Maintain confidentiality of provider credentials and personal information.
- Communicate with providers, credentialing partners, and internal teams regarding credentialing issues and delays.
- Assist with audits and other credentialing projects.
Requirements:
- 3+ years of managed care or credentialing analyst experience – Required.
- Bachelor’s degree in healthcare, business, administration, or related field – Required.
- Proficiency with Adobe Pro, Microsoft Outlook, and SharePoint – Required.
- Advanced Microsoft Excel skills, including VLOOKUP and complex formulas..
- Strong analytical, organizational, communication, and problem-solving skills.
- Experience with CAQH, TAHP, NCQA, Aperture, or NPDB – Highly Preferred.
- NAMSS certification – Highly Preferred.
- Experience with managed care regulations and provider data management – Preferred.
Remote Work Requirements:
- Must reside in Texas.
- Fully remote for eligible non-local candidates.
- Reliable high-speed internet and a secure workspace required.
- Candidate must have 2 monitors, keyboard, mouse, and webcam, or the agency must provide the equipment before the start date.
- Resume and 2 supervisory references from the past year – Required
- Skills checklist – Preferred
- Proof of Texas taxable address – Required.