Provider Enrollment & Credentialing Associate

One Behavioral Health and Alara Healthcare deliver comprehensive outpatient and inpatient behavioral health services for adults and children across the Houston area. As our organization continues to grow, we are seeking a highly organized and detail-driven Credentialing Specialist to ensure provider compliance, support operational efficiency, and uphold the highest standards of patient care.

Role Overview

The Credentialing Specialist is responsible for managing the complete credentialing and re-credentialing lifecycle for healthcare providers across multiple payers, insurance networks, and credentialing platforms. This role requires a proactive professional with strong attention to detail and follow-up skills to ensure uninterrupted provider participation, regulatory compliance, and timely billing and authorization processes. The position plays a critical role in maintaining operational continuity and supporting accurate reimbursement.

Key ResponsibilitiesCredentialing & Compliance

• Maintain, organize, and regularly update provider credentialing records for both commercial and government payers.
• Manage and monitor CAQH profiles to ensure compliance with CMS regulations and payer-specific requirements.
• Process initial credentialing, re-credentialing, and enrollment applications for Medicare, Medicaid, and commercial insurance plans.
• Manage applications, renewals, and documentation for professional licenses, DEA registrations, and controlled substance certifications.
• Complete provider revalidation processes for government and regulatory agencies within established timelines.
• Coordinate hospital credentialing activities, manage provider privileges, and maintain active provider affiliations.

Collaboration & Operational Support

• Work closely with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer issues, and authorization delays.
• Ensure accuracy and consistency of provider data across CAQH, PECOS, NPPES, CMS, and internal credentialing systems.
• Maintain a centralized credentialing tracker, including provider credentials, expiration dates, payer status, and system access details.
• Provide administrative and documentation support for credentialing audits, compliance reviews, and regulatory reporting as required.

Job Type: Full-time

Pay: Rs45,000.00 - Rs70,000.00 per month

Ability to commute/relocate:

• Wapda Town: Reliably commute or planning to relocate before starting work (Required)

Application Question(s):

• Willing to work the night shift as per US time?

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person