Quality - Credentialing | US Healthcare
3 days ago
Job Title: Quality - CredentialingDepartment: Credentialing / US Healthcare OperationsLocation: PuneJob Summary:As a Quality - Credentialing, you will be responsible for ensuring the accuracy, completeness, and compliance of credentialing processes for US healthcare professionals. Your role will focus on auditing credentialing files, validating documentation, and ensuring adherence to regulatory standards. You will work closely with credentialing associates to identify gaps, provide feedback, and support continuous improvement in credentialing quality and compliance.Key Responsibilities:- Audit credentialing files and documentation to ensure accuracy and completeness. - Validate provider credentials including licenses, certifications, and work history. - Monitor compliance with federal and state regulations, payer requirements, and internal policies. - Identify discrepancies and provide actionable feedback to credentialing associates. - Maintain quality tracking logs and generate reports on audit findings and trends. - Collaborate with the Credentialing and Quality teams to develop and refine SOPs. - Assist in training and mentoring credentialing staff on quality standards and best practices. - Participate in internal and external audits and support remediation efforts. - Stay updated on changes in credentialing regulations and industry standards. - Contribute to process improvement initiatives to enhance credentialing efficiency and accuracy.Mandatory Skills:- Strong understanding of Credentialing, Enrollment, and US Healthcare regulations. - Experience in quality assurance, compliance auditing, or credentialing operations. - Proficiency in credentialing software and databases. - Excellent attention to detail and analytical skills. - Strong communication and documentation abilities.Skills to be Evaluated On:- Knowledge of credentialing and enrollment processes. - Ability to identify and resolve compliance issues. - Accuracy in documentation and data validation. - Familiarity with US healthcare standards and payer requirements. - Collaboration and feedback delivery skills. - Reporting and audit documentation capabilities.
-
Credentialing Specialist US Healthcare
11 minutes ago
Delhi, Delhi, India AIG Business Solution Full time ₹ 9,00,000 - ₹ 12,00,000 per yearWe're Hiring | Credentialing Specialist US Healthcare Location: D21 Corporate Dwarka, New Delhi Shift: US Shift | Full-time | Work from Office Experience: 25 Years in US Healthcare Credentialing Are you skilled in managing provider credentialing, re-credentialing, and insurance enrollments within the US healthcare system? Join AIG Business Solutions –...
-
Credentialing SME
1 week ago
New Delhi, India Nath Outsourcing Solutions Pvt. Ltd. Full timeCredentialing SMEAbout the Company:Established in 2003,Nath Outsourcing Solutions Pvt. Ltd. (NOS)specializes in end-to-end solutions for theUS Healthcare Industry . Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding ofRevenue Cycle Management (RCM)concepts. With a team of...
-
Credentialing Associate
3 weeks ago
New Delhi, India InteliX Systems Full timeExciting Opportunity – Credentialing Associate at InteliX Systems We are looking for a proactive Credentialing Associate to manage all aspects of healthcare credentialing and support the smooth onboarding of healthcare professionals. This role is vital to ensuring efficient service delivery through accurate documentation and administrative coordination....
-
Credentialing Associate
4 weeks ago
New Delhi, India InteliX Systems Full timeExciting Opportunity – Credentialing Associate at InteliX SystemsWe are looking for a proactive Credentialing Associate to manage all aspects of healthcare credentialing and support the smooth onboarding of healthcare professionals. This role is vital to ensuring efficient service delivery through accurate documentation and administrative coordination. The...
-
New Delhi, India Knack RCM Full timeAbout the Role:The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers.This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client...
-
Senior Content Writer
1 week ago
Delhi, India Credex Healthcare Full timeMedical Senior Content Writer (Credentialing & RCM) (Night Shift - Remote) - Work from HomeOur client is looking for a senior medical content writer for their US Medical Credentialing & RCM business Domain working 100% Remote in US hours, 9am EST - 6pm EST. This is a full time role working 40 hours/week starting ASAP.We’re looking for someone who can:-...
-
Senior Content Writer
1 week ago
Delhi, India Credex Healthcare Full timeMedical Senior Content Writer (Credentialing & RCM) (Night Shift - Remote) - Work from HomeOur client is looking for a senior medical content writer for their US Medical Credentialing & RCM business Domain working 100% Remote in US hours, 9am EST - 6pm EST. This is a full time role working 40 hours/week starting ASAP.We’re looking for someone who can:-...
-
new delhi, India S.S Communications Full timeShould be familiar with CAQH, NPPES, PECOSWorked with multiple states credentialing for medical providersWorked on Major commercial insurancesWorked on EDI,EFT & ERA Required Candidate profileMust have min 1 year of exp in Credentialing (US RCM)Excellent written/verbal communicationGood knowledge of complete RCM process. Location- Delhi (Janakpuri east)5...
-
AR Caller
1 week ago
New Delhi, India SRZ Consulting Services Full timeCompany DescriptionWe suggest you enter details here.Role Description This is a full-time hybrid role for an AR Caller - AR Analyst - Credentialing Analyst based in Chennai, with the flexibility for some work from home. Responsibilities include managing account receivables by making calls to insurance companies and other stakeholders, analyzing accounts to...
-
Auditor- US HR
1 week ago
New Delhi, India Pride Global Full timeAbout the Company – With over 40 years of hands-on experience helping businesses worldwide tackle the challenges of the modern work landscape, we’ve been there every step of the way, providing the right people, technology, and solutions to shape a brighter future of work together.For more information, please visit our website -Pride GlobalAbout the role:...
