Provider Credentialing Specialist

6 days ago


Vellore, Tamil Nadu, India beBeeCredentialing Full time ₹ 80,00,000 - ₹ 1,20,00,000

Provider Credentialing Professional Role

We seek an experienced and detail-oriented professional to lead our provider credentialing process. This role involves managing the timely and accurate submission of provider applications, ensuring smooth onboarding, and maintaining compliance with all relevant regulations.

  • Key Responsibilities:
  • Provider Enrollment & Application Management:
  • Proven expertise in the end-to-end provider enrollment process, with proficiency in accurately completing a high volume of provider applications across various specialties and payer types.
  • Efficient submission of completed applications to relevant entities, with tracking of application statuses and proactive follow-up on outstanding items to expedite approval.
  • Welcome Kit Generation & Contract Loading:
  • Responsible for creating and disseminating comprehensive Welcome Kits for new providers, including all necessary documentation and information.
  • Accurate and efficient loading of 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, including CAQH (Council for Affordable Quality Healthcare), Medicaid, Medicare (PECOS portal), and NPI (National Provider Identifier) portals.

Requirements:

  • Bachelor's Degree in a relevant major such as Healthcare Administration, Health Information Management (HIM), Business Administration, or Public Health.
  • Expertise in provider enrollment and credentialing processes, with proficiency in managing accounts in CAQH, Medicaid, Medicare (PECOS), and NPI portals.
  • Familiarity with state-specific regulations and payer requirements, with a commitment to integrity in compliance.


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