Credentialing Specialist (Providers) at USA Vein Clinics

USA Clinics Group is a healthcare organization that works with Medicare, Medicaid, and commercial payers. They maintain a high level of organization and detail in their work, ensuring the credentialing of all their providers. The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by various entities. This includes maintaining provider files, updating databases, applying for and renewing licenses, completing re-validation requests, and working closely with other departments to resolve any issues related to provider credentialing. Responsibilities: - Maintain individual provider files - Update each provider’s CAQH database file timely - Apply for and renew annually all provider licenses - Complete re-validation requests issued by government and commercial payers - Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid - Credential new providers and re-credential current providers with hospitals - 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 various databases - Perform other duties as assigned

Credentialing Specialist (Providers)

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