Posted Feb 11, 2021 17 views
The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial
and subsequent credentialing packages as required by hospitals, surgery centers, commercial payers, Medicare and
Medicaid.
RESPONSIBILITIES
• Maintain individual provider files to include up to date information needed to complete the required
governmental and commercial payer credentialing applications
• Maintain internal provider grid to ensure all information is accurate and logins are available
• Update each provider’s CAQH database file timely according to the schedule published by CMS
• Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance
• Complete revalidation requests issued by government payers
• Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid
• Complete re-credentialing applications for commercial payers
• Credential new providers and re-credential current providers with hospitals at which they hold staff privileges
• Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or
authorization issues related to provider credentialing
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases
• Other duties as assigned
KNOWLEDGE, SKILLS, AND ABILITIES
• Knowledge of provider credentialing and its direct impact on the practice’s revenue cycle
• Detail oriented with above average organizational skills
• Plans and prioritizes to meet deadlines
• Excellent customer service skills; communicates clearly and effectively.
• Follow up with Insurances
• Having medical billing experience.
• knowledge about EHR software's
• Ability to close and help getting clients closed based on his industry knowledge and revenue cycle management process.
Perk: 5 days job , Complimentory transport, self medical Insurance and Provident Fund
Skills
Job Details
AppedologyPK Recruitment
We offer winning partnerships for mutual growth and maximized return on investment by leveraging elements of skilled employees, innovative ideas and advanced technology. The company tactfully serves an extensive portfolio of solutions specifically tailored for each client while adhering to specific IT industry guidelines and market trends so that we always stay ahead of our competitors .
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