Job Description
**Description**
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**:
KNOWLE...
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**:
KNOWLE...
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