Job description

Looking for an Experienced Credentialing Specialist as needed for New Hires (Physicians, Nurse Practitioners, and Physician Assistants) Minimum of 2 years Experience

The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by all commercial payers such as 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
• Obtain all provider licenses that are renewed; Professional, DEA, Controlled Substance (MCSR)
• 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 process, 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
• Maintain professional relationships with all payors to ensure credentialing is completely in a timely manner.
• Excellent customer service skills; communicates clearly and effectively

EDUCATION/EXPERIENCE REQUIRED

• High School Diploma or GED
• 2 years of Medical Credentialing Experience IS A MUST
• 2 years experience in a medical practice business office role or medical billing is required!

Seriously Inquires only. Competative pay and flexible schedule.

Job Type: Part-time

Pay: $20.00 - $24.00 per hour

Benefits:

• Flexible schedule

Schedule:

• Day shift

Ability to commute/relocate:

• Stoughton, MA 02072: Reliably commute or planning to relocate before starting work (Preferred)

Work Location: Hybrid remote in Stoughton, MA 02072

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