Job Title: Claims Credentialing Specialist

Location: Chicago, IL

Industry: Healthcare

Pay: $21-$26/hour

About Our Client:

Our client is a prominent healthcare organization dedicated to providing top-notch services. They offer a dynamic work environment, with opportunities for growth and professional development.

Job Description:

The Claims Credentialing Specialist is responsible for researching provider claim edits by reviewing internal rosters, state and federal rosters, and NPPE profiles for accurate information. The specialist coordinates necessary updates with managed care and internal credentialing departments and processes claims once verified and updated.

Key Responsibilities:

- Collaborate with Managed Care and Internal Credentialing departments to evaluate provider-related claim edits and denials.

- Liaise with various departments to facilitate required provider updates for billing.

- Monitor physician status until updates are marked as "complete."

- Maintain active rosters from Payers and/or Managed Care department as a primary reference.

- Address claim edits and denials stemming from credentialing issues and generate necessary reports.

- Relay pertinent issues to relevant credentialing departments and management.

- Audit credentialing work queues to ensure prompt release of charges held for pending updates in Epic and/or on the NPPES website.

- Resubmit all relevant denied claims upon completion of updates.

- Perform additional duties as assigned.

Qualifications:

- Experience with EPIC is a plus.

- Credentialing experience with managed care.

- Previous experience working with physician claim edits.

Additional Details:

- Hours: 8:00 AM - 4:30 PM.

- Dress: Business Casual

Perks:

- Opportunity to work in a prominent healthcare organization.

- Dynamic work environment with opportunities for growth.

- Hybrid work model available once permanent.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.