Quality - Credentialing | US Healthcare
1 day ago
Job Title:Quality - Credentialing Department:Credentialing / US Healthcare Operations Location: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, 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 ofCredentialing ,Enrollment , andUS Healthcare regulations . Experience inquality assurance ,compliance auditing , orcredentialing 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.
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Quality - Credentialing | US Healthcare
2 weeks ago
New Delhi, India R Systems Full timeJob 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...
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Quality - Credentialing | US Healthcare
3 weeks ago
New Delhi, India R Systems Full timeJob Title:Quality - CredentialingDepartment:Credentialing / US Healthcare Operations Location: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,...
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Quality - Credentialing | US Healthcare
3 weeks ago
New Delhi, India R Systems Full timeJob Title:Quality - Credentialing Department:Credentialing / US Healthcare Operations Location: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...
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Credentialing | U.S Healthcare
1 week ago
New Delhi, India R Systems Full timeJob Title- Executive - AR ( Credentialing )Job DescriptionAs 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...
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Credentialing Specialist US Healthcare
2 weeks 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 –...
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Credentialing SME
3 weeks 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...
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Credentialing Specialist
7 days ago
New Delhi, India PangeaEmr LLC Full timeCompany Description PangeaEmr is a USA based comprehensive solution provider for private medical practices, offering a wide range of services through a single dashboard. Our services include credentialing, medical billing, revenue cycle management, payment platforms, SEO-optimized websites, review systems, insurance verification, prior authorization, remote...
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Medical Credentialing Specialist
23 hours ago
Delhi, Delhi, India Naukri Healthcare Jobs Full time ₹ 8,00,000 - ₹ 12,00,000 per yearWe are looking for a highly skilled and experienced Medical Credentialing Specialist to join our team at beBeeMedicals. The ideal candidate will have 2-5 years of experience in medical credentialing, with a strong background in the field.Roles and ResponsibilityManage and process medical credentials for healthcare providers.Ensure compliance with regulatory...
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Credentialing Specialist
5 days ago
New Delhi, India WNS Full timeAbout the Company WNS (Holdings) Limited (NYSE: WNS) is a digital-led business transformation and services company. WNS combines deep domain expertise with talent, technology, and AI to co-create innovative solutions for over 700 clients across various industries. WNS delivers an entire spectrum of solutions including industry-specific offerings, customer...
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Director of Credentialing
1 week ago
New Delhi, India Plutus Health Inc. Full timeABOUT PLUTUS HEALTH Plutus Health is a Dallas-headquartered healthcare revenue cycle management company serving providers across multiple specialties. With 1,600+ employees in the United States, India, and the Philippines, we deliver end-to-end RCM services including medical billing, credentialing, payer enrollment, and contracting.POSITION OVERVIEW The...
