Urgent: Credentialing Specialist

4 weeks ago

Noida, India R Systems International Full time

Job Description

Role & responsibilities

- Oversee credentialing processes, ensuring compliance with industry and regulatory standards.
- Collect, review, and verify documentation such as licenses, certifications, and work history.
- Maintain and update credentialing databases with accurate and current provider information.
- Track credentialing status, expirations, and re-credentialing timelines using software tools.
- Act as the primary contact for healthcare providers, guiding them through the credentialing process.
- Collaborate with internal teams, including HR and legal, to ensure credentialing requirements are met.
- Conduct audits to identify areas for improvement and ensure compliance with policies.
- Prepare detailed reports on credentialing activities and outcomes for leadership review.
- Stay current with state and federal regulations to ensure compliance.
- Assist in developing and implementing credentialing policies aligned with best practices and organizational standards..

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