[3 Days Left] Credentialing Specialist

3 weeks ago


Bengaluru India Founders Full time

Job Description Role - Credentialing Specialist / Analyst will be responsible for meeting the set SLAs, viz, productivity, quality and attendance. Requirements - - Education: Graduates / Diploma holders - Knowledge: US Medical billing, provider credentialing - Experience: 1 to 2 years for Analyst and 3 years 5 years for specialist - Knowledge of provider credentialing and contracting with government and commercial Insurance plans - Minimum 1 year of experience in submitting applications for contracting and credentialing with Insurance plans - Excellent computer skills including Excel, Word, and Internet use - Plans and priorities to meet deadlines. Key Responsibilities - - Maintain individual provider files and group information to include up to date information needed to complete the required government and commercial payer credentialing applications. - Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. - Collect and maintain files in relation to credentialing of network providers including current provider licenses, DEA certificates, malpractice insurance, board certifications, and other pertinent forms need for enrolment - Maintain internal trackers to ensure all information is accurate and logins are available and legible - Update each provider's CAQH database file timely according to the schedule published by CMS - Complete revalidation requests issued by government payers



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