Provider Credentialing and Enrollment Expert

7 days ago

Mount Abu, Rajasthan, India beBeeCredentialing Full time ₹ 80,00,000 - ₹ 1,00,00,000

Senior Credentialing Specialist Job Summary

Our organization is seeking a highly experienced Credentialing Manager to oversee the end-to-end provider credentialing and enrollment process.

The ideal candidate will have a strong background in managing the full spectrum of provider credentialing and enrollment processes, including insurance credentialing, provider contracting, and re-credentialing.

Key Responsibilities:

  • Filing Letters of Interest and completing enrollment applications for all states
  • Engaging with payers via calls and emails to ensure successful processing of individual and group applications
  • Demonstrating expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, Medicaid MCO, and Medicare supplement/replacement plans
  • Maintaining regular communication with clients, providing updates and ensuring active status of providers with payers
  • Handling end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals
  • Managing application and renewal process for all provider licenses, including Professional, DEA, and Controlled Substance licenses
  • Ensuring 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

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