Credentialing Specialist

Duties and Responsibilities

• Ensure compliance with all regulatory, licensing, and accrediting requirements, including facility payer enrollments and state licensing requirements; communicate information to agencies and the public as required by law.
• Collaborate with ASC Operations, HR, Clinical Leadership, and Revenue Cycle departments to support provider onboarding and go-live readiness.
• Maintain credentialing trackers, status updates, and reporting to ensure visibility into enrollment timelines, expirations, and onboarding progress.
• Process and attest CAQH profiles to ensure payer enrollment accuracy and timeliness.
• Maintain Medicare PECOS enrollments, revalidations, I&A access, and surrogate relationships for providers and organizations.
• Maintain privileges and recredentialing of providers who provide services at the ASCs as well as hospitals located in the service counties.
• Maintain updated attestations and demographics for providers and facilities across various platforms.
• Act as a key point of contact for payer enrollment, recredentialing, malpractice insurance coordination, and provider-related credentialing matters across affiliated facilities and contracted health plans.
• Assist leadership with payer contracting initiatives, demographic updates, and network participation analysis.
• Track and update Providers’ CME’s and the annual requirements.
• Facilitate the completion of clearing house agreements with payers.
• Maintain EFT/ERA Agreements.
• Assist with internal audits and compliance reviews related to credentialing, payer enrollment, licensing, and provider documentation.
• Perform other duties as assigned to support operational needs.

Requirements

• Excellent verbal and written communication skills.
• Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
• Excellent organizational skills and attention to detail.
• Proficient with Microsoft Office Suite or related software.
• Proficient with or the ability to quickly learn credentialing software systems.
• Excellent time management to meet established turnaround time expectations for provider enrollments, recredentialing, privileging, and payer updates.

Education and Experience

• 2-3 years’ experience as a Credentialing Specialist, or similar role.
• Experience with credentialing software platforms (MedTrainer Preferred).
• Ability to follow instruction with minimal supervision.
• Medical Terminology.

Working Conditions

• Standard Office Setting.
• Remote optional.
• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.

Benefits

• 3 Medical plans to choose from.
• 2 Dental plans to choose from.
• A Vision Plan.
• The company provides life and accidental death & dismemberment (AD&D) insurance.
• Options to increase Life and AD&D insurance for yourself and your family.
• Short-Term Disability.
• Long-Term Disability.
• Telemedicine, Behavioral Health and medical bill auditing and redirection of medical care via Advocacy).

Schedule

Monday - Thursday: 08:00 - 05:00
Friday: 08:00 AM - 02:00 PM (Hours may vary)

Qualifications

Bi-lingual is preferred.

Integrated Pain Associates is an Equal Opportunity Employer EEO AA M/F/Vet/Disability. Qualified applicants will be considered for employment without regard to race, color, religion, national origin, sex, sexual orientation, protected veteran status or disability.