Healthcare Credentialing Professional

7 days ago

Mumbai, Maharashtra, India beBeeCredentialing Full time ₹ 12,00,000 - ₹ 15,00,000
Job Title:

Credentialing Specialist


About the Role:

We are seeking a detail-oriented Credentialing Specialist to excel in provider enrollment and credentialing. The ideal candidate will possess a strong background in provider enrollment and a comprehensive understanding of the credentialing process.

Key Responsibilities:

  • Provider Enrollment & Application Management:
  • Demonstrated expertise in the end-to-end provider enrollment process.
  • Proficiency in accurately completing a high volume of provider applications across various specialties and payer types.
  • Ensuring timely and efficient submission of all completed applications to relevant entities.
  • Tracking application statuses and proactively following up on outstanding items to expedite approval.
  • Welcome Kit Generation & Contract Loading:
  • Responsible for the creation and dissemination of comprehensive Welcome Kits for new providers, ensuring all necessary documentation and information is included.
  • Accurate and efficient loading of provider contracts into the designated system, 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): Establishing and maintaining provider profiles for efficient data sharing.
  • Medicaid: Navigating state-specific Medicaid enrollment processes.
  • Medicare (PECOS portal): Submitting and managing Medicare enrollment applications through the Provider Enrollment, Chain and Ownership System.
  • NPI (National Provider Identifier): Assisting providers in obtaining and managing their NPI numbers.

Required Skills and Qualifications:

  • Bachelor's Degree (Preferred) in a relevant major such as Healthcare Administration, Health Information Management (HIM), Business Administration, or Public Health.
  • An associate's degree combined with relevant work experience may suffice for entry-level roles.
  • Excellent Communication and Interpersonal Skills.
  • Ability to Work Independently and as Part of a Team.
  • Proficiency in Google Sheets and Docs.
  • Excellent Typing Skills.
  • Comprehensive Knowledge of Computer Usage and Navigation.

What We Offer:

A challenging role that demands a detail-oriented professional with a strong ethical foundation, technical proficiency, and a drive for performance excellence in credentialing.

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