Hollstadt Consulting · 17 hours ago

Credentialing Specialist

Minnesota, United States

Contract

Remote

Entry, Mid Level

$23.49/hr - $29.43/hr

2+ years exp

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Consulting

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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 databases 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

Apply for and renew annually all provider licenses; Professional, DEA, Controlled Substance

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

Work closely with the 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

Communicate with interdisciplinary teams on status of credentialing and needs to get work completed

Other duties as assigned

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Credentialing StandardsCredentialing CyclesDocument ReviewHIPAA ComplianceDatabase ManagementHealthcare ExperienceRecord KeepingCompliance Standards