Credentialing Specialist

USA Clinics Group is growing and seeking a motivated

Credentialing Specialist

to join our team! 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, and regulatory agencies.

RESPONSIBILITIES

Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applicationsMaintain internal provider grid to ensure all information is accurate and logins are availableUpdate each provider's CAQH database file timely according to the schedule published by CMSApply for and renew annually all provider licenses; Professional, DEA, Controlled SubstanceComplete re-validation requests issued by government and commercial payersComplete credentialing applications to add providers to commercial payers, Medicare, and MedicaidComplete re-credentialing applications for commercial payersCredential new providers and re-credential current providers with hospitals at which they hold staff privilegesWork closely with the Billing and Authorizations Departments to identify and resolve any denials or authorization issues related to provider credentialingMaintain accurate provider profiles on ECHO, CAQH, PECOS, NPPES, and CMS databasesOther duties as assignedRequirements

1 year of prior credentialing experience in a non-hospital setting,

requiredAssociates Degree,

required,

Bachelors Degree,

preferredKnowledge of provider credentialing and its direct impact on the practice's revenue cycleDetail oriented with above average organizational skillsExcellent customer service skills; communicates clearly and effectivelyBenefits

HealthDentalVision401kPTO