The Credentialing Specialist will be responsible for the following::
Have knowledge of NCQA standards, delegated credentialing and Primary Source Verification.
Have knowledge of health plan credentialing and enrollment including Medicare and Medicaid.
Have ability to prepare and/or update the providerâ��s CAQH application for newly affiliated and existing healthcare providers for initial and recredentialing activity.
The ability to build and maintain peer-to-peer relationships with all relevant market and national health plans.
Establish credentialed status to facilitate billing for multiple specialties.
Maintain and update credentialing databases completely and accurately and ensures up-to-da
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