Healthcare Professional

18 hours ago

Ajmer, Rajasthan, India beBeeCredentialing Full time ₹ 9,00,000 - ₹ 12,16,250
Job Title:

Provider Credentialing Specialist

About the Job:

This is a crucial role in ensuring timely and accurate submission of provider applications, facilitating smooth onboarding, and maintaining compliance with all relevant regulations. The ideal candidate will possess a strong background in provider enrollment and a comprehensive understanding of the credentialing process.

The provider enrollment specialist will be responsible for ensuring that all necessary documents and information are included in Welcome Kits for new providers. They will also be responsible for accurately loading provider contracts into designated systems, ensuring all terms and conditions are correctly captured.

The applicant portal expert must have extensive experience in creating and managing accounts within key healthcare application portals, including CAQH, Medicaid, Medicare (PECOS portal), NPI, and regional credentialing advantage.

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.
  • Regional Credentialing Advantage:
  • Experience working with providers specifically in Florida will be considered a significant advantage, demonstrating familiarity with state-specific regulations and payer requirements.
Requirements:
  • Education:
  • Bachelor's Degree in a relevant major such as Healthcare Administration, Health Information Management (HIM), Business Administration, or Public Health.
  • Experience:
  • Expertise in provider enrollment and credentialing processes, ensuring ethical and accurate completion and submission of applications across various specialties and payers (e.g., Medicaid, Medicare).
  • Technical Skills:
  • High proficiency in Google Sheets (formulas, pivot tables, charts) and Google Docs, supporting a high-performance culture through efficient workflows.
  • Strong Knowledge:
  • Operating systems, software, and browsers to uphold professional performance standards.

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