Administrative - Credentialing Specialist (Days)

MedlinkHealth Anesthesia • Dallas, TX

1d • Remote

About The Position

We are seeking a detail-oriented and analytical Credentialing Analyst to support managed care credentialing programs in compliance with federal, state, and NCQA accreditation requirements. In this role, you will evaluate healthcare practitioners and facilities upon network entry, conduct ongoing provider reviews, oversee delegated/non-delegated provider data, and maintain accurate provider directory metrics. This position offers fully remote flexibility for qualified candidates residing within the state.

Requirements

• Minimum 3+ years of managed care or credentialing analyst experience
• Bachelor’s degree in Healthcare, Business, or Health Administration
• Advanced skills in Microsoft Excel (VLOOKUP, complex formulas/functions), Adobe Pro, Microsoft Outlook, and SharePoint
• Exceptional analytical skills, strong problem-solving initiative, and clear verbal/written communication abilities.

Nice To Haves

• Prior experience with CAQH, TAHP, NCQA accreditation, Aperture, or the National Provider Data Bank (NPDB)
• National Association Medical Staff Services (NAMSS) certification (CPCS or CPMSM)
• Familiarity with managed care statutes and provider data management practices

Responsibilities

• Verify and process initial credentialing and re-credentialing applications for practitioners and facilities to ensure compliance with NCQA and regulatory standards.
• Gather, analyze, and track provider data for directory updates, billing setup, and internal reporting using advanced spreadsheet tools and database portals.
• Assist with oversight audits of delegated and non-delegated provider groups; identify data discrepancies, and recommend process improvements.
• Interface with credentialing databases and partner organizations to streamline application processing and resolve provider inquiries.
• Maintain strict confidentiality regarding provider credentials and personal information while adhering to state and organizational credentialing policies.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level