Credentialing Specialist Job at Quadrant, Bethesda, MD

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  • Quadrant
  • Bethesda, MD

Job Description

Credentialing Specialist Bethesda MD

Pay From: $25 per hour

MUST: The Credentialing Specialist should have the following:

  • 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: The duties of the Credentialing Specialist include but are not limited to the following:

  • 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".

Job Tags

Hourly pay

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