Company Description
Integrated Pain Associates is a physician-led, multi-site pain management group dedicated to restoring function and improving quality of life for patients suffering from chronic pain. With clinics and surgical centers across Texas, our practice combines advanced interventional techniques with compassionate, patient-centered care.
Job summary
The Credentialing Specialist oversees provider credentialing, recredentialing, payer enrollment, and privileging processes to ensure providers remain compliant, properly enrolled, and operationally ready to deliver patient care across all affiliated facilities, surgery centers, and contracted health plans. This role also supports payer contracting initiatives by facilitating credentialing-related communications, demographic updates, and enrollment activities associated with contract negotiations and network participation.
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.
- Initiate and maintain Medicare PECOS enrollments, revalidations, I&A access, and surrogate relationships for providers and organizations.
- Initiate and 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.
- Initiate and maintain EFT/ERA Agreements.
- Assist with internal audits and compliance reviews related to credentialing, payer enrollment, licensing, and provider documentation
- Participate in the restructuring of internal credentialing processes.
- Perform other duties as assigned to support operational need.
Required Skills
- 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
- Travel on occasion
- 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)
Bi-lingual is preferred.
Integrated Pain Associates in 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.
