Provider Credentialing Specialist
4 weeks ago
**USA Clinics Group** is seeking a detail oriented **Credentialing Specialist **who 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.
**This position is located on-site at our Corporate Headquarters located in Northbrook, Illinois**
**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
- Performs other duties as assigned
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