Healthcare Contracting and Credentialing Expert

1 day ago

Ghaziabad, Uttar Pradesh, India beBeeCredentialing Full time US$ 60,000 - US$ 95,000
Job Description

We are seeking a skilled Contracting and Credentialing Specialist to join our team. The ideal candidate will have experience in US-based contracting and credentialing processes for healthcare providers.

The successful candidate will be responsible for handling contracting and credentialing needs for healthcare providers, diagnostic laboratories, and medical facilities as preferred providers in health care networks.

  • Prepare, submit, and manage contracting and credentialing applications to insurance payors across multiple US states
  • Communicate with payors, clinicians, and verification bodies, track application progress, and ensure timely follow-ups and completion; proactive payor contact to ensure applications are filled out correctly
  • Assist with hiring and onboarding clinicians and act as primary point of contact for all affiliated clinicians
  • Maintain accurate records and update dashboards, tracking tools, and other documents as required
  • Alert providers of new regulations, expiring certificates, reapplications, and deficiencies in credentialing requirements.
  • Work with internal teams to correct and/or amend rejected contracting applications; update internal workflows to reflect current best practices based on up-to-date payor and industry requirements as well as advise on potential concerns or improvements.
  • Train team members with varying levels of experience and seniority in contracting and credentialing processes.
Required Skills and Qualifications

To succeed in this role, you will need:

  • At least 2 years' experience in US-based contracting and credentialing process for providers
  • Deeply familiar with US medical insurance industry and have worked with multiple insurance providers through the credentialing process. Medicaid and Medicare experience is a plus
  • Excellent English speaking, listening, and written communication skills and dependably high levels of responsiveness
  • Able to work autonomously with minimal supervision, report regularly, and execute work plans thoroughly
  • Highly organized and detail-oriented with strong follow-up skills
  • Comfortable using Google Workspace, tracking tools, and internal platforms
  • BYOD - must have a secure device compatible with required software/applications (e.g. VPN, Google workspace) and be willing to adhere to company security practices
Benefits

As a valued member of our team, you can expect:

  • A collaborative work environment
  • Opportunities for professional growth and development
  • A chance to make a meaningful impact in the field of healthcare
Others

If you are data-driven, detail-oriented, and capable of wearing multiple hats, we would love to hear from you.

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