Credentialing Specialist

Credentialing Specialist Bethesda MD Pay From: $25 per hour Musts 2+ years of credentialing providers on the insurance side commercial and Medicaid/Medicare Entering and updating data from provider applications into credentialing database Reviewing applications for accuracy and completeness Handling Primary Source Verification thru any of these sites: OIG, NPBD, CAQH, NPPES and Student Clearing House Tracking and following-up on verifications in the processing applications Reviewing and validating documents Look for discrepancies and correct Track and follow up on verifications Comfortable working in a high volume setting Strong documentation skills and administrative support skills Organized and detailed CPCS certification or currently pursuing High School Diploma or GED Duties Handle credentialing of providers with commercial insurance payers as well as Medicare and Medicaid Review credentialing applications for accuracy and completeness Handle Primary Source Verification thru OIG, NPBD, CAQH, NPPES and Student Clearing House Maintain and update database Enter and update data from provider applications into credentialing database Review and validate licensure Prepare and provide information to payors and staff Submit the provider rosters to payors with delegated status Track and follow-up on verifications in the processing of applications Quadrant is an affirmative action/equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, status as a protected veteran, or status as an individual with a disability. "Healthcare benefits are offered to all eligible employees according to compliance mandated by the Affordable Care Act". #J-18808-Ljbffr Quadrant, Inc.