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Remote Credentialing Auditor Jobs in Texas (NOW HIRING)

MMC Group

DRG Auditor

San Antonio, TX · Remote

... remote DRG Validation Auditors. As members of the DRG Validation Team and working remotely ... Possess current AHIMA credentials (RHIT/RHIA/CCS), with current CCS preferred * Demonstrate ...

University Health

Coding Educator/Auditor

San Antonio, TX · Remote

$25.10 - $40.25/hr

Provides onsite and remote quality assurance reviews/audits with appropriate compliance with ... Valid credential(s) from the American Health Information Management Association (AHIMA) and/or ...

University Health

Coding Educator/Auditor

San Antonio, TX · Remote

$23.50 - $26.75/hr

Provides onsite and remote quality assurance reviews/audits with appropriate compliance with ... Valid credential(s) from the American Health Information Management Association (AHIMA) and/or ...

Moffitt

$91K - $139K/yr

Remote. Candidates must reside in the Tampa Bay region, including Pasco, Hillsborough, Pinellas ... Credentials and Experience Required: * Bachelor's Degree in Accounting or related field. * CPA, CIA ...

Datavant

Auditor, HCC Risk Adjustment Coding

Dallas, TX · Remote

$29 - $32/hr

AHIMA certified credentials (RHIA, RHIT, CCS) or AAPC certified credentials (CPC, CPC-H, COC, CIC ... Excellent written and verbal communication skills, ability to work in a remote environment and time ...

Datavant

Inpatient Audit Specialist- PRN

Houston, TX · Remote

$35 - $45/hr

As an Inpatient Auditing Specialist, you will be instrumental in addressing consulting and ... This role is fully remote with a flexible schedule, allowing you to help shape the future of health ...

MyCHN

Population Health Manager

Pearland, TX · Remote

Manage reporting, auditing, budgeting, and operational performance * Ensure adherence to HIPAA ... remote patient monitoring, or a related healthcare function * Minimum of two years of supervisory ...

MyCHN

Population Health Manager

Pearland, TX · Remote

Manage reporting, auditing, budgeting, and operational performance * Ensure adherence to HIPAA ... remote patient monitoring, or a related healthcare function * Minimum of two years of supervisory ...

RG Search

Corporate Controller

Austin, TX · On-site +1

Investment Real Estate Company Location: (remote) - based in Austin Compensation: up to $215,000 ... Drive external audit and tax engagements; prepare schedules and respond to auditor/taxrequests.

ForeFlight

Principal Security Engineer

Austin, TX · On-site +1

$180K - $220K/yr

This is a fully remote role in US. Key Responsibilities Security Architecture * Define and ... Translate auditor findings and regulatory obligations into concrete engineering work - not policy ...

AE Perkins

Data Team Supervisor

Dallas, TX · On-site +1

$105K - $120K/yr

Remote-First with In-Person Training: This position is remote following successful completion of ... Establish and maintain auditing processes to ensure data accuracy and quality across all data ...

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Remote Credentialing Auditor information

What is the difference between Remote Credentialing Auditor vs Remote Credentialing Specialist?

AspectRemote Credentialing AuditorRemote Credentialing Specialist
Required credentialsHealthcare-related certifications, compliance knowledgeHealthcare credentials, licensing, and certification knowledge
Work environmentRemote, healthcare or insurance organizationsRemote, healthcare facilities or insurance companies
Employer usageHealthcare providers, insurance companies, credentialing firmsHospitals, clinics, insurance companies, healthcare networks

The Remote Credentialing Auditor primarily reviews and verifies credentials for compliance and accuracy, focusing on auditing processes. In contrast, the Remote Credentialing Specialist manages the credentialing process, ensuring providers meet all licensing and certification requirements. Both roles require healthcare credentials and often work remotely within healthcare or insurance industries, but their core responsibilities differ—auditing versus processing credentialing applications.

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Credentialing Specialist

Integrated Pain Associates

Killeen, TX • Remote

Full-time

Medical, Dental, Vision, Life

Re-posted 10 days ago

Job description

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 amp;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 amp; dismemberment (AD amp;D) insurance.
  • Options to increase Life and AD amp;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.

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