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: www.colehealth.com

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