Credentials Liaison Specialist

Bracane Co

  • Plano, Texas
  • 30+ days ago

    Highlights

    The Credentials Specialist serves as the central point of coordination for employment background checks, drug screening, license and certification verification, payer enrollment, EVV compliance, HIPAA compliance, and vendor registrations with healthcare facilities, hospitals, and government agencies. This position ensures that nurses, home health aides, caregivers, contractors, and organizational vendors meet all regulatory, payer, licensing, and contractual requirements prior to providing services.

    Numbers & Facts

    LocationPlano, Texas

    Description

    We are hiring candidates for Madea Home Care Services, LLC

    Administration / Human Resources / Compliance

    Position Summary

    Will oversee and manage all credentialing, compliance, verification, and onboarding activities for clinical and non-clinical personnel at Madea Home Care Services. This position ensures that nurses, home health aides, caregivers, contractors, and organizational vendors meet all regulatory, payer, licensing, and contractual requirements prior to providing services.

    The Credentials Specialist serves as the central point of coordination for employment background checks, drug screening, license and certification verification, payer enrollment, EVV compliance, HIPAA compliance, and vendor registrations with healthcare facilities, hospitals, and government agencies.

    This role is critical to maintaining organizational compliance with Texas HHSC, CMS, Medicare, Medicaid, VA/Tricare, HIPAA, and other federal, state, and local regulatory standards.

    Essential Duties & Responsibilities Credentialing & Compliance Oversight

    • Manage and oversee all credentialing activities for:
    • Registered Nurses (RNs)
    • Licensed Vocational Nurses (LVNs)
    • Home Health Aides (HHAs)
    • Certified Nursing Assistants (CNAs)
    • Personal Caregivers
    • Contractors and agency representatives

    Verify and maintain:

    • Professional licenses
    • Certifications
    • CPR credentials
    • Insurance documentation
    • Continuing education requirements

    Drug Screening Coordination

    Payer & Insurance Credentialing

    Commercial insurance plans

    Private pay programs

    EVV & HIPAA Compliance

    Monitor EVV exceptions and reporting requirements

    Vendor Registration & Contract Compliance

    Client Intake & Referral Coordination

    Assist with client intake and referral coordination processes

    Assist with verification of payer eligibility and authorization status for services

    Maintain communication with referral sources and families regarding onboarding status and service coordination

    Support continuity of care by ensuring referrals are transitioned efficiently into active service cases

    Maintain accurate intake and referral tracking logs for compliance, reporting, and audit purposes

    Documentation & Record Management

    Maintain accurate and organized credentialing files

    Monitor expiration dates and renewal requirements

    Prepare documentation for:

    Surveys

    Audits

    Accreditation reviews

    Regulatory inspections

    Maintain credentialing dashboards and compliance tracking systems

    Qualifications Education

    Associate's or Bachelor's degree in:

    Healthcare Administration

    Business Administration

    Human Resources

    Nursing

    Related field preferred

    Experience

    Minimum 3-5 years of experience in:

    Healthcare credentialing

    Home health administration

    Compliance management

    Payer enrollment

    Regulatory coordination

    Experience with:

    Medicare/Medicaid enrollment

    EVV systems

    HIPAA compliance

    Vendor registration platforms

    Knowledge, Skills & Abilities

    Strong knowledge of:

    Texas HHSC regulations

    CMS requirements

    HIPAA compliance

    Credentialing standards

    Excellent organizational and documentation skills

    Ability to manage multiple deadlines and compliance requirements

    Strong communication and problem-solving abilities

    Proficiency with:

    Credentialing databases

    Microsoft Office

    EVV systems

    Electronic health records (EHR)

    Compliance Expectations

    The Credentials Manager is expected to:

    Maintain confidentiality at all times

    Adhere to Madea Home Care Services policies and procedures

    Support survey readiness and audit preparedness

    Promote ethical and compliant operational practices

    Physical Requirements

    Prolonged sitting and computer use

    Ability to communicate effectively with staff and external agencies

    Occasional travel for meetings or credentialing support, if required

     

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