Provider Credentialing and Enrollment Manager

1 week ago

Aurangabad, Maharashtra, India beBeeCredentialing Full time ₹ 12,00,000 - ₹ 15,00,000

Provider Credentialing Specialist Job Description:

We are seeking experienced professionals to join our team as Provider Credentialing Specialists. As a key member of our credentialing team, you will be responsible for managing the full spectrum of provider credentialing and enrollment.

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 the 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 the 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 the 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 the ability to work independently in a remote setting.
  • Proficiency in using credentialing portals and managing the associated documentation.
  • Exceptional communication skills to effectively engage with both clients and payers.
Bonus Skills
  • Microsoft Office Suite proficiency.
  • Electronic medical records (EMR) management skills.
  • Compliance knowledge with state and federal regulations.

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