Job Summary Universal Health is a physician-owned medical practice serving post-acute and long-term care facilities. We are continuously striving to provide best-in-class experience for our patients and our employees. Reporting to the Practice Manager, the Healthcare Credentialing Specialist will be responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by insurance companies and UHC facilities. Duties/Responsibilities : Work closely with Talent Acquisition, HR, and Operations to complete credentialing in timely manner. Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing. 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 Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. 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 Credential new providers and re-credential current providers with hospitals at which they hold staff privileges. Add providers to Modio Health System Other duties as assigned. Required Skills/Abilities: Strong written and verbal communication and interpersonal skills, with the ability to build rapport with physicians, advance practice providers, employees, and other members of the public. Strong organizational skills and attention to detail Strong time management skills with a proven ability to meet deadlines Proficient with Microsoft Office Suite and EMR systems Education and Experience High School Diploma or GED 3+ years of credentialing experience preferred 2 years experience in a medical practice business office role preferred
Salary: $45,000 - $50,000 a year
Employment Type: Full-time
Qualifications
[]