Position Summary
The Credentialing Specialist ensures clinicians successfully pass the credentialing process. This role is responsible for assisting clinicians with the completion of their credentialing applications , performing primary source verifications , and maintaining the MD Staff credentialing database. The Specialist must ensure all credentialing functions comply with internal policies, client health plan contracts, URAC guidelines, NCQA standards, and applicable state and federal requirements. This position reports to the Credentialing Supervisor.
Key Responsibilities
Review and process credentialing and re-credentialing files.
Establish and maintain a system for the timely processing of credentialing files in accordance with NCQA policies.
Query appropriate organizations and evaluate responses to ensure provider compliance with NCQA standards.
Maintain copies of current state licenses, DEA certificates, malpractice coverage, and other required credentialing documents for all providers.
Review all background checks, drug tests, and TB screenings and record the results.
Assemble all verified information and prepare files for presentation to the Credentialing Committee.
Verify providers requirements for approval to work in specific states and plans.
Assist with the ongoing monitoring of contracted clinicians.
Utilize the MD Staff credentialing database to perform queries, generate reports, and optimize efficiency.
Provide administrative support to department leadership and both internal and external stakeholders.
Maintain professionalism at all times 17and provide timely, professional responses to all emails.
Actively demonstrate teamwork and assist with special projects.
Responsible for the security and privacy of any protected health information (PHI) accessed during work activities.
Required Qualifications
1-3 years of successful work experience in a credentialing role/department.
Intermediate skills with Google Suites.
Must be familiar with NCQA accreditation standards.
Demonstrate active listening skills and the ability to provide and receive constructive feedback
Strong interpersonal skills, with the ability to build rapport and productive relationships with internal and external stakeholders
Preferred Qualifications
Obtain NAMSS Certification as a Certified Provider Credentialing Specialist (CPCS) within 2 years of eligibility to certify.
Working knowledge of problem-solving and decision-making skills.
Ability to organize and prioritize workload and day-to-day tasks.
Education
High school diploma or up to 1 year of equivalent experience.
INTAKE CALL NOTES
Key Details
Openings: 1
Start Date: August 3, 2026
End Date: December 31, 2026 (extension/conversion possible)
Work Schedule:
7:30 AM 4:30 PM CST
Work Location:
Fully remote (U.S.)
If Dallas-based: onsite approximately 2x/month (every other Tuesday)
Drug Screen: Required
Internet Requirement: Must provide reliable internet (speed test screenshot required for remote workers)
Top Required Skills:
1. Medical Staff Credentialing Experience
Minimum 13%2B years of credentialing experience required
Strong preference for medical staff (hospital-based) credentialing
NOT targeting provider enrollment backgrounds (Medicare/Medicaid/payer enrollment)
2. Primary Source Verification (PSV)
Must have hands-on experience completing PSV, including:
State licenses
DEA
Malpractice coverage
Background checks and screenings
3. NCQA Knowledge & Compliance
Working knowledge of NCQA standards
Ability to maintain compliance and ensure accuracy of credentialing files
4. Google Suite & Systems Proficiency (CRITICAL)
Must be comfortable using:
Google Sheets, Docs, Gmail
Experience working within credentialing systems (MD Staff or similar strongly preferred)
Strongly Preferred
25 years total credentialing experience
Experience in hospital or health system environments
Experience preparing files for credentialing committee review
MD Staff system experience
NAMSS/CPCS certification (not required)
Candidate Profile What Good Looks Like
Has processed credentialing files independently
Strong attention to detail and compliance accuracy
Able to manage multiple files and meet deadlines
Comfortable working in a fast-paced, remote environment
Demonstrates strong communication and organizational skills
DO NOT SUBMIT
Candidates with only provider enrollment / payer enrollment experience
Candidates with no credentialing experience
Candidates lacking Google Suite proficiency
Entry-level administrative profiles without relevant credentialing background
Candidate Submission Requirements
Candidates must include the following responses at the top of their resume:
Years of credentialing experience
Type of credentialing (medical staff vs provider enrollment)
Weekly credentialing volume handled
Description of primary source verification experience
Experience with NCQA standards
Credentialing systems used (MD Staff or similar)
Google Suite experience (Sheets, Docs, Gmail)
Experience in hospital or health system credentialing
Work schedule availability (alignment to required hours)
Location and remote/onsite flexibility
Enable Skills-Based Hiring: No
Country Code
US
Experience Level
Level I (0-3 Years)
Is Hardware Required
Yes
Remote
Skills:
Accreditation Standards, Administrative Skills, Certified Provider Credentialing Specialist (CPCS), Communication Skills, Contract Management, Detail Oriented, Establish Priorities, File Management, Health Plan, Healthcare Providers, Hospital, Information/Data Security (InfoSec), Interpersonal Skills, Leadership, Maintain Compliance, Medicaid, Medicare, National Committee for Quality Assurance (NCQA), Organizational Skills, Physician Credential, Presentation/Verbal Skills, Privacy Controls, Problem Solving Skills, Regulatory Compliance, Reporting Skills, Systems Maintenance, Team Player, Time Management, United States Drug Enforcement Agency (DEA), Utilization Review Accreditation Commission (URAC)
Apidel Technologies