Job Description:
-Submission of initial and re credentialing of applications to contracted payers.

-Maintenance of licensures and renewal process.

-Caqh updates, NPPES enrollment, quality review roster delegation, data entry in symplr payer.

-Primary source verification on boards and licensures.

-Follow ncqa, AAAHC, URAC, JC guidelines

What software skills are needed? Excel, word, Smartsheet, PowerPoint. Symplre payer, cactus, Symplr Payer, Pecos, MD Staff

Candidate must be familiar with CA rules and regulations – CMS guidelines, CAQH, and MediCal