Healthcare Credentialing Professional

2 days ago

Thoothukudi, Tamil Nadu, India beBeeCredentialing Full time ₹ 8,00,000 - ₹ 12,00,000

Job Title: Provider Credentialing Professional

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A Credentialing Specialist plays a vital role in ensuring timely and accurate submission of provider applications, facilitating smooth onboarding, and maintaining compliance with all relevant regulations.

Key Responsibilities:
  • Provider Enrollment & Application Management:
  • Demonstrate expertise in the end-to-end provider enrollment process.
  • Proficiency in accurately completing a high volume of provider applications across various specialties and payer types.
  • Ensure timely and efficient submission of all completed applications to relevant entities.
  • Track application statuses and proactively follow up on outstanding items to expedite approval.
Welcome Kit Generation & Contract Loading:
  • Responsible for the creation and dissemination of comprehensive Welcome Kits for new providers, ensuring all necessary documentation and information is included.
  • Accurately and efficiently load provider contracts into designated systems, ensuring all terms and conditions are correctly captured.
Application Portal Expertise:
  • Extensive experience in creating and managing accounts within key healthcare application portals.
  • Establish and maintain provider profiles for efficient data sharing in CAQH.
  • Navigate state-specific Medicaid enrollment processes.
  • Submit and manage Medicare enrollment applications through PECOS.
  • Assist providers in obtaining and managing their NPI numbers.
Regional Credentialing Advantage:
  • Experience working with providers specifically in Florida will be considered a significant advantage.
  • Demonstrating familiarity with state-specific regulations and payer requirements.
Communication & Responsiveness:
  • Maintain a high level of professionalism and responsiveness in all email communications.
  • Promptly address queries and provide clear, concise information to internal and external stakeholders.
Compliance & Confidentiality:
  • Adhere strictly to HIPAA regulations.
  • Maintain confidentiality of sensitive patient and provider information.
  • Ensure all credentialing activities are in full compliance with federal, state, and organizational guidelines.

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