National Spine & Pain Centers, management services organization for the nation's largest group of interventional pain management practices, is seeking a Credentialing Specialist to join our Managed Care team! Candidates can work from one of our office locations.
Education and Experience
High school degree or equivalent education and training, required.
Minimum of three (3) years of credentialing experience, required.
Familiarity with CAQH, NDBP, PECOS, license verification, and credentialing software required.
Familiar with licensing requirements for both physicians and mid-level providers.
Familiar with Medicare enrollment procedures and protocols.
Compiles and maintains current and accurate data for all providers.
Completes provider credentialing and re-credentialing applications; monitors applications and follows-up as needed.
Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
Maintains knowledge of current health plan and agency requirements for credentialing providers.
Sets up and maintains provider information in credentialing databases and system.
Tracks license and certification expirations for all providers to ensure timely renewals.
Ensures practice addresses are current with health plans, agencies, and other entities.
Processes applications for appointment and reappointment of privileges to facilities
Ability to work in a fast paced high volume work environment.
Ability to maintain confidentiality of privileged information at all time.
Ability to work independently, productively, and be able to meet project timelines.
Must have satisfactory background check inclusive of driving, criminal, employment reference, education, and social security.
Telecommuting is allowed.
Internal Number: MGDCR
About National Spine & Pain Centers
At National Spine & Pain Centers (NSPC), our mission is to relieve pain and improve quality of life through personalized, accessible care.