Provider Credentialing Expert

3 days ago

Mysore, Karnataka, India beBeeCredentialing Full time ₹ 12,00,000 - ₹ 15,00,000
Senior Credentialing Specialist

A detail-oriented professional with experience in provider credentialing and enrollment is required to manage the full spectrum of provider credentialing and enrollment.

Key Responsibilities:
  • Manage provider credentialing and enrollment processes, including filing Letters of Interest and completing enrollment applications for all states.
  • Engage with payers via calls and emails to ensure successful processing of individual and group applications.
  • Demonstrate expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, Medicaid MCO, and Medicare supplement/replacement plans.
  • Maintain regular communication with clients, providing updates and ensuring active status of providers with payers.
  • Handle end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals.
  • Manage application and renewal process for all provider licenses, including Professional, DEA, and Controlled Substance licenses.
  • Ensure continuous updating and maintenance of client and application data, readily available for client requests.

Requirements:

  • A minimum of 5 years of experience in provider credentialing and enrollment.
  • Strong organizational skills and ability to work independently in a remote setting.
  • Proficiency in using credentialing portals and managing associated documentation.
  • Exceptional communication skills to effectively engage with both clients and payers.

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