Job Description
Schedule: Monday through Friday either 8am-5pm or 9am-6pm
Pay Rate: $20-$22/hr (depending on experience)
REQUIREMENT: Bilingual English/Spanish preferred
Location: Hybrid Remote/In-Clinic or Fully Remote
Clinic Location: 16835 Deer Creek Drive, Spring, TX 77379
Company Website: Job Description: Clinical Specialist The Credentialing Specialist is responsible for managing the credentialing and re-credentialing process for licensed therapists - including Speech-Language Pathologists (SLPs), Occupational Therapists (OTs), and Physical Therapists (PTs) - ensuring compliance with regulatory, accreditation, and organizational standards. This role verifies provider qualifications, licenses, certifications, and work history to support patient safety, risk management, and payer enrollment requirements.
Key Responsibilities - Process initial credentialing and re-credentialing applications for speech, occupational, and physical therapists
- Perform primary source verification of state licenses, national certifications (e.g., ASHA CCC-SLP, NBCOT, NPTE), education, clinical training, malpractice history, and work references
- Maintain accurate and up-to-date provider files in credentialing software/databases (e.g., CAQH, Symplr, MD-Staff)
- Track and manage expiration dates for licenses, certifications, CEUs, and liability insurance coverage; proactively initiate renewal processes
- Coordinate with clinical operations, insurance payers, and facility/agency partners to complete enrollment and privileging
- Ensure compliance with NCQA, URAC, Joint Commission, CMS, state licensing boards, and payer-specific requirements
- Prepare credentialing files and reports for internal review and audits
- Communicate with therapists to obtain missing documentation or clarify discrepancies
- Respond to inquiries from internal departments, payers, and external agencies regarding credentialing status
- Maintain confidentiality of sensitive provider information in accordance with HIPAA
- Assist with internal and external audits related to credentialing compliance
- Monitor state-specific licensure requirements across multiple jurisdictions if supporting multi-state practice or telehealth therapy services
Required Qualifications - High school diploma or equivalent required; associate or bachelor's degree preferred
- 2+ years of experience in credentialing, healthcare administration, or a therapy/rehab services setting
- Familiarity with credentialing software and databases
- Strong understanding of credentialing standards (NCQA, URAC, Joint Commission) and therapy-specific licensure/certification bodies (state PT/OT/SLP boards, ASHA, NBCOT, FSBPT)
- Excellent organizational skills and high attention to detail
- Strong written and verbal communication skills
- Ability to manage multiple priorities and meet deadlines
- Proficiency in Microsoft Office (Excel, Word, Outlook)
Preferred Qualifications - Certified Provider Credentialing Specialist (CPCS) certification
- Experience with payer enrollment processes for rehab/therapy services
- Experience credentialing across multiple states (for multi-state or telehealth practices)
- Knowledge of HIPAA and healthcare compliance regulations
Work Environment - Office-based, hybrid, or fully remote depending on organization
- May require occasional overtime during audit periods or high-volume credentialing cycles
Job Tags
Work at office, Remote work, Monday to Friday