Medical Credentialing Professional

hace 1 semana


Tijuana, Baja California, México Usa Clinics Group A tiempo completo

We are seeking a highly organized Medical Credentialing Professional to join our team at Usa Clinics Group. The successful candidate will be 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, and regulatory agencies.

Key Responsibilities:

• Maintain an accurate provider grid to ensure all information is up-to-date and logins are available
• Update each provider's CAQH database on time 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
• Collaborate closely with the Billing and Authorizations Departments to identify and resolve any denials or authorizations issues related to provider credentialing
• Maintain accurate provider profiles on ECHO, CAQH, PECOS, NPPES, and CMS databases

Requirements:

• Strong 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
• Ability to plan and prioritize tasks to meet deadlines
• Excellent customer service skills; communicates clearly and effectively

Compensation:

The estimated salary for this position is approximately $65,000 - $85,000 per year, depending on experience and qualifications.

Benefits:

• 100% IMSS coverage
• Vacation time (after the first year)
• Christmas bonus
• Paid training
• Weekends off
• Mexican Holidays off
• Eligibility for additional employee benefits as provided by the company in the future



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