Credentialing Specialist Job at DNA Comprehensive Therapy Services, Fort Myers, FL

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  • DNA Comprehensive Therapy Services
  • Fort Myers, FL

Job Description

Job Description

Job Description

Description:

The Credentialing Specialist is responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by commercial payers, Medicare, and Medicaid.

Requirements:

  • Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.
  • Maintain internal provider grid to ensure all information is accurate.
  • 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
  • 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.
  • Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing.
  • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.

PREFERRED KNOWLEDGE, SKILLS, AND ABILITIES

  • Athena, NextGen, MD-Staff experience
  • 2 years credentialing experience
  • 2 years’ experience in a medical practice business office role

EDUCATION/EXPERIENCE REQUIRED :

High School Diploma or GED

This position earns competitive compensation plus a full benefits package including medical, dental, vision, and life insurance, annual PTO of 15 days with tenure recognition incentives, one additional paid day for your birthday and Employee Assistance Program. We also offer opportunities for growth, as well as a great team atmosphere that empowers you to take ownership of outcomes in providing quality service and support.

Requirements:

Job Tags

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