What are the responsibilities and job description for the Credentialing Specialist position at Midwest Vision Partners?
Job Description
As the Credentialing Specialist, you will be responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by Medicare, Medicaid, commercial payers, hospitals, and regulatory agencies. This role ensures that all providers are properly credentialed to deliver care while maintaining compliance with applicable standards.
About Midwest Vision Partners
Vision is a precious gift. Midwest Vision Partners (MVP) is focused on improving and preserving it for as many patients as possible by cultivating a network of world-class ophthalmologists and optometrists who provide exceptional, patient-centered care. Headquartered in Chicago, MVP proudly supports prominent eye care professionals in 70 locations across Ohio, Michigan, Pennsylvania, West Virginia, and Illinois, with over 140 physicians and 1,500 employees all focused on delivering top-notch, customized results for each of our patients.
Key Responsibilities
Alpine Investors is a private equity firm with offices in San Francisco, New York City, and Salt Lake City. With over $16 billion in assets under management and a strong performance record, Alpine focuses on its PeopleFirst philosophy-investing in exceptional individuals to build enduring companies and deliver market-leading results.
Job Posted by ApplicantPro
As the Credentialing Specialist, you will be responsible for maintaining active status for all providers by successfully completing initial and subsequent credentialing packages as required by Medicare, Medicaid, commercial payers, hospitals, and regulatory agencies. This role ensures that all providers are properly credentialed to deliver care while maintaining compliance with applicable standards.
About Midwest Vision Partners
Vision is a precious gift. Midwest Vision Partners (MVP) is focused on improving and preserving it for as many patients as possible by cultivating a network of world-class ophthalmologists and optometrists who provide exceptional, patient-centered care. Headquartered in Chicago, MVP proudly supports prominent eye care professionals in 70 locations across Ohio, Michigan, Pennsylvania, West Virginia, and Illinois, with over 140 physicians and 1,500 employees all focused on delivering top-notch, customized results for each of our patients.
Key Responsibilities
- Maintain individual provider files with up-to-date information needed to complete required governmental and commercial payer credentialing applications.
- Maintain the internal provider grid to ensure all information is accurate and logins are available.
- Update each provider's CAQH database in accordance with the schedule published by CMS.
- Apply for and annually renew all provider licenses, including Professional, DEA, and Controlled Substance licenses.
- Complete re-validation requests issued by government and commercial payers.
- Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid.
- Complete re-credentialing applications for commercial payers.
- Credential new providers and re-credential current providers with hospitals at which they hold staff privileges.
- Work closely with the Billing and Authorizations Departments to identify and resolve any denials or authorization issues related to provider credentialing.
- Maintain accurate provider profiles on ECHO, CAQH, PECOS, NPPES, and CMS databases.
- Perform other duties as assigned.
- Competitive wages
- Robust benefits package including medical, dental, life, and disability (short- and long-term) insurance
- Generous paid time off (PTO) program
- Seven (7) company-paid holidays
- 401(k) retirement plan with company match
- An organization focused on People, Passion, Purpose, and Progress
- Inspirational, team-oriented culture
- High school diploma or GED equivalent
- 1-2 years of credentialing experience
- 1-2 years of experience in a medical office setting
- Strong knowledge of ECHO (One App), CAQH, PECOS, NPPES, and CMS databases
- Knowledge of provider credentialing and its direct impact on the practice's revenue cycle
- Associate's degree
Alpine Investors is a private equity firm with offices in San Francisco, New York City, and Salt Lake City. With over $16 billion in assets under management and a strong performance record, Alpine focuses on its PeopleFirst philosophy-investing in exceptional individuals to build enduring companies and deliver market-leading results.
Job Posted by ApplicantPro