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Job Details

Credentialing Specialist - San Antonio, TX


Clinical Care Specialist/Staff Nurse


San Antonio, Texas, United States

Opportunities at WellMed, part of the Optum family of businesses. We believe all patients are entitled to the highest level of medical care. Here, you will join a team who shares your passion for helping people achieve better health. With opportunities for physicians, clinical staff and non-patient-facing roles, you can make a difference with us as you discover the meaning behind Caring. Connecting. Growing together.  

The Credentialing Specialist is responsible for processing credentialing and re-credentialing applications in accordance with department expectations, policies and procedures and regulatory requirements.

Positions in this function are responsible for all activities associated with credentialing or re-credentialing physicians, providers, and facilities. Includes processing provider applications and re-applications including initial mailing, review, and loading into the database tracking system ensuring high quality standards are maintained. May conduct audits and provide feedback to reduce errors and improve processes and performance. Responsible for the development of credentialing policies and procedures. May oversee primary source verification activities.

Primary Responsibilities:

  • Apply knowledge/skills to a range of moderately complex activities
  • Demonstrate great depth of knowledge/skills in own function
  • Sometimes act as a technical resource to others in own function
  • Proactively identify solutions to non-standard requests
  • Solve moderately complex problems on own
  • Work with team to solve complex problems
  • Plan, prioritize, organize, and complete work to meet established objectives
  • May coordinate work of other team members
  • Oversee, facilitate, complete receipt and processing of provider applications
  • Oversee, facilitate, complete analysis and verification of provider credentials
  • Maintain provider credentialing documentation
  • Develops, supports, monitors, and oversees quality of network providers

You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

Required Qualifications:

  • High school diploma/GED or equivalent work experience
  • 1+ years of administrative, database and/or data entry experience
  • Intermediate level of proficiency with MS Excel and Word
  • Must live within a commutable distance to San Antonio, TX

Preferred Qualifications:

  • 2+ years of healthcare provider credentialing experience
  • Experience maintaining confidentiality while working with sensitive information
  • Detail-oriented, well-organized and have the ability to multi-task effectively

At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone–of every race, gender, sexuality, age, location and income–deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes — an enterprise priority reflected in our mission.

Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

UnitedHealth Group is a drug - free workplace. Candidates are required to pass a drug test before beginning employment.