Provider Credentialing Specialist - Northbrook, United States - USA Clinics Group

USA Clinics Group

Verified Company

Northbrook, United States

1 week ago

Posted by:

Mark Lane

beBee recruiter

Description

USA Clinics Group is seeking a detail oriented
Credentialing Specialist who 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.

This position is located on-site at our Corporate Headquarters located in Northbrook, Illinois

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 revalidation requests issued by government and commercial payers
Credential new providers and recredential 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
Performs other duties as assigned