What are the responsibilities and job description for the Credentialing Specialist (Texas) position at NMFS?
About Us
New Mexico Family Services (NMFS) is a growing mental and medical health clinic dedicated to providing compassionate, accessible care to individuals and families in our community. Our team supports a wide range of services, and we pride ourselves on creating a welcoming, supportive environment for both our clients and staff.
Position Overview
We are seeking a knowledgeable and detail-oriented Credentialing Specialist with experience in Texas provider credentialing to join our growing team.
This role is ideal for someone who understands the full credentialing lifecycle and can confidently manage provider enrollment, revalidation, and compliance across multiple payers—particularly within Texas Medicaid, Medicare, and commercial insurance networks.
You will play a key role in ensuring our providers are properly credentialed, enrolled, and maintained to support uninterrupted patient care and billing operations.
Key Responsibilities
- Manage end-to-end provider credentialing for Texas-based payers
- Complete and submit provider applications for:
- Texas Medicaid (TMHP)
- Medicare (PECOS)
- Commercial insurance panels
- Track application status, follow up with payers, and resolve delays
- Maintain accurate and up-to-date provider files (CAQH, licenses, certifications, NPI, etc.)
- Handle re-credentialing and revalidation cycles to ensure continuous enrollment
- Verify provider credentials including education, licensure, and work history
- Ensure compliance with federal, state, and payer-specific requirements
- Collaborate with billing, administration, and clinical teams to prevent service interruptions
- Assist with audits, reporting, and documentation as needed
Qualifications
- Required:
- Proven experience (5 years) with Texas provider credentialing
- Familiarity with TMHP, Medicare (PECOS), and commercial payers
- Strong understanding of credentialing workflows, timelines, and compliance standards
- Experience maintaining CAQH profiles and provider documentation
- High attention to detail and strong organizational skills
- Preferred:
- Experience in a medical, behavioral health, or multi-specialty clinic setting
- Knowledge of billing processes and insurance verification
- Familiarity with multi-state credentialing (NM TX a plus)
What We’re Looking For
- Someone proactive, organized, and able to manage multiple deadlines
- A problem-solver who can navigate payer systems and follow through
- A professional who values accuracy, compliance, and accountability
- A team player who communicates effectively across departments
Why Join NMFS?
- Meaningful work supporting mental and medical health services
- Collaborative, mission-driven team environment
- Opportunity to grow with an expanding healthcare organization
- Flexible scheduling options based on role needs
How to Apply
Please submit your resume along with a brief summary of your credentialing experience, including your familiarity with Texas payers and systems.
New Mexico Family Services is an equal opportunity employer and values diversity in the workplace.
Job Types: Full-time, Part-time
Pay: $35,000.00 - $46,000.00 per year
Work Location: In person
Salary : $35,000 - $46,000