Credential Specialist US Medical Billing

Experience 1 to 3 years

Notice period Immediate or 15 days

Job Description:

• Should have experience in the credential process for various Medical Insurances including HMOs IPAs
• Maintain individual provider files to include up-to-date information needed to complete the required governmental and commercial payer credentialing applications.
• Maintain contracted Managed Care Organizations, commercial payers, CMS Medicare, Medicaid, PECOS, NPPES, and CAQH tracking log to ensure all necessary portals logins are active and available.
• Work with individual providers to ensure each provider s CAQH database files are updated timely according to the schedule published by CMS Medicare/ Medicaid and Managed Care Organizations regulations.
• Responsible of ensuring provider collected information is current and accurate.
• Keep track of the expiration date for the state DEA license, Board certification, and Malpractice insurance of individual providers.