Credentialing Coordinator

3 weeks ago

delhi, India EMPClaims Full time
EMPClaims was recently recognized as a Top 10 vendor for RCM Services in the US, and we take pride in the quality of our services. Our customers include large health systems and small medical practices.
We offer you a competitive compensation package along with the opportunity to learn on the job, develop knowledge of the process, and grow your career.
Position Summary:
The Credentialing Specialist is responsible for managing the credentialing process for healthcare providers to ensure compliance with insurance company and government regulations. This role involves verifying and maintaining provider credentials, facilitating enrollment in healthcare networks, and ensuring timely reimbursements for services rendered.
Key Responsibilities:
Initiate and complete the credentialing process for healthcare providers, including physicians, nurse practitioners, and other clinical staff.
Verify and review provider education, training, licensure, certifications, and work history to ensure compliance with industry standards and regulations.
Facilitate the enrollment of providers in various healthcare networks, including Medicare, Medicaid, and private insurance plans.
Maintain up-to-date knowledge of payer enrollment requirements and deadlines.
Maintain accurate and up-to-date provider credentialing information in the organization's databases and credentialing software.
Ensure that all credentialing activities are conducted in compliance with industry standards and legal requirements.
Provide regular updates on the status of provider credentialing to management and relevant stakeholders.
Qualifications:
Bachelor's degree in healthcare administration, business, or a related field (preferred).
Previous experience in provider credentialing within a healthcare setting is highly desirable.
Knowledge of healthcare regulations, payer enrollment requirements, and industry standards.
Strong attention to detail and organizational skills.
Excellent communication and interpersonal skills.
Proficiency in using credentialing software and Microsoft Office applications.
Ability to work independently and as part of a team.
Problem-solving skills and the ability to handle confidential information with discretion.
Company Benefits:
5 days working.
Attractive & realistic performance incentives
Provident Fund/ESIC
Extreme employee engagement
Maternity/Paternity leaves.
Employee specific career progression Plans.
Learning & Development (Technical, Soft skills, Communication, Leadership)
Rewards and Recognition programs
Safe Commute for female night shift employees
Festival celebrations & annual events

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