Healthcare Contracting and Credentialing Professional

3 days ago

Bareilly, Uttar Pradesh, India beBeeCredentialing Full time US$ 70,500 - US$ 98,700
US Contracting and Credentialing Specialist

We are seeking a highly skilled US contracting and credentialing specialist to join our team. The ideal candidate will have extensive experience in the US-based contracting and credentialing process for providers, as well as excellent communication skills and a strong ability to work autonomously.

The successful candidate will be responsible for handling contracting and credentialing needs for our US-based health care providers, diagnostic laboratories, and medical facilities as preferred providers in health care networks. This includes preparing, submitting, and managing contracting and credentialing applications to insurance payors across multiple U.S. states, communicating with payors, clinicians, and verification bodies, tracking application progress, and ensuring timely follow-ups and completion.

Key Responsibilities:

  • 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.

What You Bring:

  • At least 2 years experience in the US-based contracting and credentialing process for providers.
  • Deeply familiar with the US medical insurance industry and have worked with multiple insurance providers through the credentialing process. Medicaid and Medicare experience is a plus.
  • Excellent English speaking, listening, and written communication skills and dependably 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 be willing to adhere to company security practices.

Why Work with Us:

We offer a dynamic and supportive work environment where you can grow professionally and make a meaningful impact. Our team is dedicated to delivering quality healthcare outcomes and improving the patient journey through innovative technology and strategic partnerships.

Join us at Forta where you can leverage your skills and expertise to drive business growth and improve lives.

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