Credentialing Senior Associate
4 weeks ago
As a leading RCM organization in the industry, we offer a comprehensive range of services, including BPO and RCM. Our organization provides its team members with training and solutions to learn and grow across various technologies and processes. As an innovator and leader in e-health services, we offer unparalleled growth opportunities in the industry.
What You Can Expect from Us:
- A safe digital application and onboarding process
- Health Insurance Accidental Insurance Both sides pick up and Drop facility/ Self Transport Allowance
- Subsidized Meals
- Fun at Work
- Career Growth - Best in the Industry
- Merit Increment - Best in the Industry
- Employee Friendly Environment
- Best HR Practices
- Secured workplace for employees
- Ample scope of Reward and Recognitions
Responsibilities:
- Should have working experience in US Healthcare - Credentialing Process-Payer and Provider Processes.
- Ensure credentialing processes are following professional standards, bylaws, state and federal regulatory requirements.
- Oversee day-to-day operational credentialing and privileging activities. Collaborating with the Credentialing Manager to ensure proper functioning of activities, policies, and procedures.
- Acting as a resource and subject matter expert, resolving issues, Coordinating with Credentialing contacts regarding the credentialing process.
- Verifying primary source data, such as provider education, board certifications, licensure, and other eligibilities /documents.
- Work on experience in All modules of CAQH. Overall, should be expertise with CAQH.
- Ensuring timely credentialing and re-credentialing of network providers and working with Internal/External Team to ensure credentialing files completed within timeframe and compliance.
- Calling Payers for Enrollment application status and take necessary action
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