Healthcare Provider Enrollment Specialist

1 day ago

Ahmedabad, Gujarat, India beBeeCredentialing Full time ₹ 7,20,000 - ₹ 10,80,000

Expert Provider Credentialing Specialist Opportunity

This role is ideal for professionals with a strong background in end-to-end provider enrollments, insurance credentialing, and recredentialing.

Key Responsibilities:

  • Manage the full spectrum of provider credentialing and enrollment, including filing letters of interest and completing enrollment applications for all states.
  • Engage with payers via calls and emails to ensure successful processing of both 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.

Benefits:

  • Remote work environment
  • Opportunity to work with a variety of healthcare organizations
  • Chance to develop expertise in provider credentialing and enrollment

Others:

  • Fast dedicated laptop/PC I5+, 8GB Ram, Windows 10/11 (licensed and activated), MS Office 2013 + (working copy)
  • Quiet home office with no distractions
  • Fast internet connection (minimum 50MB+)

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