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Credentialing Specialist


Responsible for all aspects of the credentialing, re-credentialing, and privileging processes for all medical providers who provide patient care at Southwest Gastroenterology Associates and Southwest Endoscopy, Ltd. Responsible for ensuring providers are credentialed, appointed, and privileged with health plans, hospitals and patient care facilities. Maintain up-to-date data for each provider in credentialing databases and online systems; ensure timely renewal of licenses and certification.


  1. Compiles and maintains current and accurate data for all providers.

  2. Completes provider credentialing and re-credentialing applications; monitors applications and follows up as needed.

  3. Maintains copies of current state licenses, DEA certificates, malpractice coverage, and any other required credentialing documents for all providers.

  4. Maintains knowledge of current health plan and agency requirements for credentialing providers.

  5. Sets up and maintains provider information in online credentialing databases and systems.

  6. Tracks license and certification expirations for all providers to ensure timely renewals.

  7. Ensures practice addresses are current with health plans, agencies, and other entities.

  8. Processes applications for appointment and reappointment of privileges to Southwest Endoscopy, Ltd.

  9. Tracks license, DEA, and professional liability expirations for appointed ASC providers.

  10. Maintains ASC appointment files and information in the credentialing database.

  11. Audits health plan directories for current and accurate provider information.

  12. Maintains confidentiality of provider information.

  13. Provides credentialing and privileging verifications.

  14. Performs other duties as assigned.

Required Education and Experience

  1. · High School Diploma or GED

  2. · Associate Degree, preferred

  3. · Certified Provider Credentialing Specialist (CPCS), preferred

  4. · Two years of relevant credentialing experience

Performance Requirements


  • Knowledge and understanding of the credentialing process.


  • Ability to organize and prioritize work and manage multiple priorities.

  • Excellent verbal and written communication skills, including letters, memos, and emails.

  • Excellent attention to detail.

  • Proficient use of Microsoft Office applications (Word, Excel, Access) and internet resources.


  • Ability to research and analyze data.

  • Ability to work independently with minimal supervision.

  • Ability to establish and maintain effective working relationships with providers, management, staff, and contacts outside the organization.

Work Environment

  • Standard office environment.​


  • Standard office equipment.


  • Hearing: Adequate to perform job duties in person and over the telephone.

  • Speaking: Must communicate clearly in person and over the telephone.

  • Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.

  • Other: Requires occasional lifting and carrying items weighing up to 20 pounds unassisted. Requires frequent bending, reaching, and repetitive hand movements, standing, walking, squatting, and sitting, with some lifting, pushing, and pulling exerted regularly throughout a regular work shift.

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