Provider Credentialing Specialist
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 providers 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 practices revenue cycle
Excellent computer skills including Excel, Word, and Internet use
Detail oriented with above average organizational skills
Plans and prioritizes to meet deadlines
Excellent customer service skills; communicates clearly and effectively
EDUCATION/EXPERIENCE REQUIRED
High School Diploma or GED
2 years credentialing experience preferred
2 years experience in a medical practice business office role required
Job Type: Full-time
Expected hours: 40 per week
Benefits:
401(k)
Dental insurance
Disability insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance
Schedule:
Monday to Friday
Location:
Georgia (Required)
Work Location: Remote
Apply Now
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 providers 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 practices revenue cycle
Excellent computer skills including Excel, Word, and Internet use
Detail oriented with above average organizational skills
Plans and prioritizes to meet deadlines
Excellent customer service skills; communicates clearly and effectively
EDUCATION/EXPERIENCE REQUIRED
High School Diploma or GED
2 years credentialing experience preferred
2 years experience in a medical practice business office role required
Job Type: Full-time
Expected hours: 40 per week
Benefits:
401(k)
Dental insurance
Disability insurance
Employee assistance program
Flexible spending account
Health insurance
Health savings account
Life insurance
Paid time off
Vision insurance
Schedule:
Monday to Friday
Location:
Georgia (Required)
Work Location: Remote
Apply Now