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 Medicare and Medicaid, commercial payers, hospitals, regulatory agencies.

RESPONSIBILITIES
- 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
- Complete re-validation requests issued by government and commercial payers
- Credential new providers and re-credential current providers with hospitals at which they hold staff privileges
- Work closely with the Billing and Authorizations Departments to identify and resolve any denials or authorization issues related to provider credentialing
- Maintain accurate provider profiles on ECHO, CAQH, PECOS, NPPES, and CMS databases
- Additional duties as assigned

**Requirements**:
KNOWLEDGE, SKILLS, AND ABILITIES
- Knowledge of provider credentialing and its direct impact on the practice’s 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

**Benefits**
- MSS 100%
- Vacations (after the first year)
- Christmas bonus
- Paid Training
- Weekends off
- Mexican Holidays off

You will also be eligible for any additional employee benefits that the company may provide in the future.