"Credentialing Specialist"

2 weeks ago


Ahmedabad, India Aqkode Healthcare Services & Solutions Full time
  • Require a minimum 6 months to 1 year of experience.
  • Required good communication skills (Both written and verbal)
  • Working knowledge of the current basics of Microsoft Office.
  • Prioritization and multi-task skills are required.
  • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
  • Set up and maintain CAQH/PECOS; maintain all provider-payer data supporting the best reimbursement performance.
  • Complete provider enrollments with Medicare/Medicare and all private payers. Set up all ERA and EFT enrollments.
  • Perfect provider experience and achieve the shortest turnaround time.
  • Perform complete payer network research, verify provider's credentials, and provide accurate timelines and open panel availability.
  • Send clients a complete checklist of all the documents required to file the enrollment applications.
  • Build quality assurance processes for a flawless enrollment submission; perform appeals for closed panels.
  • Complete out-of-network enrollments and NPI registrations on the payer's website for providers who chose or are forced to stay out-of-network.
  • Follow-up regularly and frequently on enrolment application status until the contract comes through.



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