Verified Job
Jobs
Credentialing Specialist
Jobs
#475430
Full Time
Job Description
Require a minimum 6 months to 1 year of experience.
• Required good communication skills (Both written and verbal)
• Working knowledge of the current basics of Microsoft Office.
• Prioritization and multi-task skills are required.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Set up and maintain CAQH/PECOS; maintain all provider-payer data supporting the best reimbursement performance.
• Complete provider enrollments with Medicare/Medicare and all private payers. Set up all ERA and EFT enrollments.
• Perfect provider experience and achieve the shortest turnaround time.
• Perform complete payer network research, verify provider's credentials, and provide accurate timelines and open panel availability.
• Send clients a complete checklist of all the documents required to file the enrollment applications.
• Build quality assurance processes for a flawless enrollment submission; perform appeals for closed panels.
• Complete out-of-network enrollments and NPI registrations on the payer's website for providers who chose or are forced to stay out-of-network.
• Follow-up regularly and frequently on enrolment application status until the contract comes through.
• Required good communication skills (Both written and verbal)
• Working knowledge of the current basics of Microsoft Office.
• Prioritization and multi-task skills are required.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Set up and maintain CAQH/PECOS; maintain all provider-payer data supporting the best reimbursement performance.
• Complete provider enrollments with Medicare/Medicare and all private payers. Set up all ERA and EFT enrollments.
• Perfect provider experience and achieve the shortest turnaround time.
• Perform complete payer network research, verify provider's credentials, and provide accurate timelines and open panel availability.
• Send clients a complete checklist of all the documents required to file the enrollment applications.
• Build quality assurance processes for a flawless enrollment submission; perform appeals for closed panels.
• Complete out-of-network enrollments and NPI registrations on the payer's website for providers who chose or are forced to stay out-of-network.
• Follow-up regularly and frequently on enrolment application status until the contract comes through.
