call center senior representative inbound.

Credentialing Lifecycle Management: Perform comprehensive credentialing and re-credentialing for all practitioners (physicians, mid-level providers, and allied health staff).Primary Source Verification (PSV): Meticulously conduct and document all PSV requirements, including state licenses, DEA certificates, board certifications, education, training, and malpractice history.Compliance & Audit Readiness: Ensure all provider files and processes adhere strictly to standards set by regulatory bodies (e.g., CMS, Texas State Boards) and accrediting organizations (e.g., NCQA, The Joint Commission).Database Administration: Accurately input, maintain, and update provider data in the credentialing software (e.g., Cactus, MD-Staff, etc.), tracking expiration dates and managing deficiency logs.Payer Enrollment: Facilitate the provider enrollment and re-enrollment process with various commercial and government payers (Medicare/Medicaid).Committee Coordination: Prepare applications and reports for review by the Credentialing Committee, ensuring all materials are complete and presented in a timely manner.Communication: Serve as the primary point of contact for providers and their office staff, resolving inquiries related to credentialing status and documentation requirements.

1-4 years

Certified Professional Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) certification.Bilingual (English/Spanish) skills strongly preferred due to the regional location.

Residency Requirement: Must physically reside in the Brownsville, McAllen, or surrounding Rio Grande Valley area of Texas.Experience: Minimum of 2-3 years of dedicated experience in healthcare credentialing, medical staff services, or payer enrollment.Education: High School Diploma or equivalent required. Associate's or Bachelor's degree preferred.Knowledge: Strong understanding of credentialing standards, compliance requirements, and state/federal regulations in a healthcare setting.Technical Proficiency: Demonstrated experience working with a medical credentialing software/database. Proficient in Microsoft Office (Word, Excel, Outlook).Skills: Exceptional organizational, analytical, and problem-solving skills with a critical attention to detail.

Bachelors