Credentialing Specialist

Credentialing Specialist

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Integrated Pain Associates is changing the pain journey by delivering individualized care plans and innovative technology to achieve maximum effective results with minimally invasive procedures.

Job Summary: The Credentialing Specialist manages all aspects of credentialing, re‑credentialing, and appointment processes for medical providers in clinics, surgery centers, and hospitals. Responsibilities include enrollment with health plans, maintaining up‑to‑date provider data, and ensuring timely renewal of licenses and certifications.

• Maintain compliance with regulatory and accrediting institutions.
• Credential and re‑credential physicians, mid‑level health professionals.
• Track applications for physician hospital privileges.
• Track enrollment applications with various payers for the physician group, individual providers, and ambulatory surgery centers.
• Manage provider credentialing information via electronic files and Med Trainer.
• Maintain and update CAQH online credentialing application.
• Monitor clinical licenses for all providers and notify of upcoming expirations.
• Maintain CME records and required training courses.
• Obtain malpractice insurance for new providers and renew yearly policies.
• Obtain and track state licenses for the physician group and ASC’s.
• Maintain privileges and reappointment of providers performing procedures in the ASC.
• Maintain required attestations and demographics for providers and facilities across payer platforms quarterly.
• Engage in contract negotiations with insurance payers and communicate changes to stakeholders.
• Assist in developing internal credentialing processes.
• Communicate with clinic staff and billing department regarding inquiries.
• Maintain payer agreements with the clearinghouse for the billing department.
• Initiate and maintain EFT/ERA agreements for the billing department.
• Create provider portals or add/remove users as needed.
• Perform other duties as assigned.

• Excellent verbal and written communication skills.
• Excellent interpersonal skills with the ability to manage sensitive and confidential situations with tact, professionalism, and diplomacy.
• Strong organizational skills and attention to detail.
• Proficiency with Microsoft Office Suite or related software.

• 2–3 years’ experience as a Credentialing Specialist or similar role.
• Experience with Med Trainer preferred.
• Ability to follow instructions with minimal supervision.
• Knowledge of medical terminology.
• Experience with Microsoft Office (1 year preferred).
• Qualification in credentialing (2 years required).

• 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.

• 3 medical plans to choose from.
• 2 dental plans to choose from.
• A vision plan.
• Life and accidental death & dismemberment (AD&D) insurance.
• Options to increase life and AD&D insurance for yourself and your family.
• Short‑term and long‑term disability.
• Freshbenies (Telemedicine, behavioral health, and medical bill auditing and redirection of medical care via advocacy).

Schedule: Monday – Thursday: 08:00 – 17:00. Friday: 08:00 – 14:00 (hours may vary).

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.

Mid-Senior level

Full‑time

Health Care Provider

Medical Practices