Credentialing Specialist

Job Title: Credentialing Specialist
Location: Quest Pediatric Therapy – Moore, Norman, or OKC
Position Type: Part-Time or Full-Time (based on candidate preference and clinic needs)
Reports To: Director of Front and Back Office

Position Summary

The Credentialing Specialist is responsible for managing the credentialing and recredentialing processes for all Speech, Occupational, and Physical Therapists across Quest Pediatric Therapy’s three locations. This role ensures that provider information is up to date, accurately submitted, and in compliance with payer requirements, including Medicaid, private insurance panels, and credentialing platforms such as CAQH and Availity.

This position can be structured as part-time or full-time. If full-time, up to 25% of the role may involve additional supervisory responsibilities related to front office operations, training, or support staff oversight, depending on candidate qualifications and clinic needs.

Key Responsibilities

• Manage and track initial credentialing, re-credentialing, and enrollment of all providers with payers including Medicaid and commercial insurance plans
  
  


• Maintain and update provider information in CAQH, Availity, and other portals as needed
  
  


• Ensure timely submission and renewal of credentialing paperwork, licenses, and required documents
  
  


• Serve as a liaison between clinicians, insurance companies, and office staff to ensure seamless credentialing and billing processes
  
  


• Track expirations and renewals of licensure, certifications, and other time-sensitive documents
  
  


• Collaborate with billing and administrative staff to verify credentialing accuracy and resolve related issues
  
  


• Maintain accurate digital records and ensure compliance with HIPAA and organizational policies
  
  

Preferred Qualifications

• 2+ years of experience in medical office administration, preferably in credentialing, billing, or insurance verification
  
  


• Familiarity with CAQH, Availity, Oklahoma Medicaid, and commercial payer systems
  
  


• Strong organizational skills with attention to detail and time-sensitive tasks
  
  


• Ability to communicate effectively and professionally with a variety of stakeholders
  
  


• Comfortable working independently and collaboratively in a fast-paced environment
  
  


• Leadership or supervisory experience is a plus, especially for candidates interested in a full-time role
  
  

Compensation

• Hourly Range: starting at $20.00 per hour, pay will be based on experience and qualifications
  
  


• Eligible for benefits if full-time (30+ hours/week)