Healthcare Contracting and Credentialing Specialist

2 weeks ago

Kolkata, West Bengal, India beBeeContracting Full time US$ 65,000 - US$ 85,000

Job Description

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We are on a mission to simplify the healthcare process by delivering quality services with maximum convenience. Autism support via Applied Behavior Analysis (ABA) is challenging to access, and the current delivery model must be expanded to provide earlier access to families.

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To achieve this goal, we are developing software and predictive algorithms that enable clinicians to work smarter by surfacing relevant case data. Our team is committed to continuously improving the patient journey and delivering personalized care by applying smart technology and investing in our world-class team.

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In this role, you will handle contracting and credentialing needs for health care providers, diagnostic laboratories, and medical facilities as preferred providers in health care networks.

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Responsibilities:

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  • Prepare, submit, and manage contracting and credentialing applications to insurance payors across multiple U.S. states\
  • Communicate with payors, clinicians, and verification bodies, track application progress, and ensure timely follow-ups and completion; this includes proactive payor contact to ensure applications are filled out correctly\
  • Assist with hiring and onboarding clinicians and act as the 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.
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About You

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  • A minimum of 2 years' experience in the US-based contracting and credentialing process for providers.\
  • Deep understanding of the US medical insurance industry and experience working with multiple insurance providers through the credentialing process. Medicaid and Medicare experience is beneficial.\
  • Excellent English speaking, listening, and written communication skills, along with 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 adhere to company security practices.
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