Credentialing Specialist - Medical Billing

To process insurance applications To follow up on the credentialing application
• To negotiate the contracts with insurance
• Get provider Ids from insurance once credentialing is complete
• Maintain provider profiles perfectly CAQH profile creation and updating NPI Registration and updates
• State License registration and renewals
• Work with provider office managers and IPAs DEA Registration and updates Payer Fee Schedule Creation & Evaluation
• Sending reminders to providers for upcoming expirations and renewals
• Experience with commercial and government insurance enrollments.

Responsibilities:
• Exceptional communication skills.
• Good interpersonal and decision-making skills.
• Ability to work independently and as part of a team.
• Willing to work in night shift (7PM to 4AM)

Client communication

Client data verification

Payer verification

Application submissions

Insurance communications

Reporting and Analysis

Contract review and execution

Appeals and dispute management