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Credentialing Specialist
4 weeks ago
Job Description:
We are seeking a detail-oriented and proactive Credentialing Analyst to manage the end-to-end credentialing process for healthcare providers. This role involves timely onboarding, payor credentialing, documentation, and compliance tracking to ensure all providers meet regulatory and client requirements.
Key Responsibilities:
• Manage onboarding of new providers, including welcome communication, documentation, and source verification.
• Handle Collaborative Agreements and update provider records in systems like Athena and CredentialMyDoc (CMD).
• Submit and track payor applications and rosters; ensure follow-ups with payors.
• Allocate and prioritize tasks via CMD based on daily workload.
• Maintain and update CAQH profiles every 120 days for active providers.
• Conduct monthly OIG verifications and ensure compliance with client requirements.
• Prepare regular reports on credentialing holds, provider onboarding status, and facility credentialing by payor.
• Respond promptly to credentialing-related emails and follow-ups within 24 hours.
• Participate in weekly calls with internal stakeholders and clients.
• Maintain and update SOPs related to credentialing.
Requirements:
• Prior experience in healthcare credentialing or provider onboarding preferred.
• Work From Office (Ahmedabad Only)
• Excellent communication skills in English, both written and verbal.
• Strong attention to detail, organization, and time management.
• Familiarity with systems like Athena, CMD, and CAQH is an advantage.
Qualification:
• Graduation in any stream.
• Prior experience in healthcare credentialing or provider onboarding is preferred.
