Quality - Credentialing | US Healthcare

11 hours ago


Pune, India R Systems Full time

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.



  • Pune, India R Systems Full time

    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...


  • pune, India R Systems Full time

    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...


  • pune, India R Systems Full time

    Job Title: Quality - Credentialing Department: Credentialing / US Healthcare Operations Location: Pune Job 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...


  • Pune, Maharashtra, India R Systems International Full time ₹ 12,00,000 - ₹ 36,00,000 per year

    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...


  • Pune, Maharashtra, India R Systems Full time ₹ 4,50,000 - ₹ 7,50,000 per year

    Job Title:Quality - CredentialingDepartment:Credentialing / US Healthcare OperationsLocation:PuneJob Summary:As aQuality - 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,...


  • Pune, India R Systems Full time

    Job Title: Quality - Credentialing Department: Credentialing / US Healthcare Operations Location: Pune Job 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...


  • Pune, India R Systems Full time

    Job Title- Executive - AR ( Credentialing ) Job Description As a Credentialing Associate at R Systems, you will play a pivotal role in ensuring the accurate and timely processing of credentialing applications for US healthcare professionals. Your expertise in regulatory compliance, attention to detail, and ability to manage multiple tasks will be critical in...


  • Pune, India R Systems Full time

    Job Title- Executive - AR ( Credentialing ) Job Description As a Credentialing Associate at R Systems, you will play a pivotal role in ensuring the accurate and timely processing of credentialing applications for US healthcare professionals. Your expertise in regulatory compliance, attention to detail, and ability to manage multiple tasks will be critical in...


  • Pune, India R Systems Full time

    Job Title- Executive - AR ( Credentialing ) Job Description As a Credentialing Associate at R Systems, you will play a pivotal role in ensuring the accurate and timely processing of credentialing applications for US healthcare professionals. Your expertise in regulatory compliance, attention to detail, and ability to manage multiple tasks will be critical in...


  • Pune, India R Systems Full time

    Job Title- Executive - AR ( Credentialing ) Job Description As a Credentialing Associate at R Systems, you will play a pivotal role in ensuring the accurate and timely processing of credentialing applications for US healthcare professionals. Your expertise in regulatory compliance, attention to detail, and ability to manage multiple tasks will be critical in...