Senior Provider Enrollment Specialist

1 week ago

Noida, Uttar Pradesh, India beBeeCredentialing Full time ₹ 1,50,00,000 - ₹ 2,00,00,000
Job Title: Team Leader - Credentialing

 

Overview:

US Healthcare Operations is a leading provider of healthcare solutions.

 

Our company seeks a dynamic and experienced Team Leader - Credentialing to oversee and manage a credentialing team within the US healthcare domain.

 

The ideal candidate will be responsible for ensuring timely and accurate provider enrollment, re-credentialing, and compliance with payer and regulatory standards.

Key Responsibilities:
  • Lead and supervise daily operations of the credentialing team, ensuring adherence to client, payer, and regulatory guidelines.
  • Manage end-to-end provider enrollment and re-credentialing processes with insurance networks, hospitals, and healthcare facilities.
  • Review provider documentation for accuracy, completeness, and compliance prior to submission.
  • Monitor turnaround times and ensure timely completion of credentialing tasks.
  • Serve as the primary escalation point for complex credentialing issues, collaborating with payers and providers for resolution.
  • Train, mentor, and evaluate team members to uphold quality standards and meet productivity goals.
  • Generate and analyze reports on credentialing status, performance metrics, and compliance indicators.
  • Coordinate with internal departments, clients, and third-party entities to streamline credentialing workflows.
  • Stay updated on payer policies, NCQA standards, and healthcare compliance regulations.
  • Identify and implement process improvements to enhance operational efficiency and client satisfaction.

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