US Health Care Contracting and Credentialing Expert

1 week ago

Ellore, Andhra Pradesh, India beBeeCredentialing Full time ₹ 15,00,000 - ₹ 25,00,000

Clearing the Path to Quality Healthcare

Forta is a leading provider of Applied Behavior Analysis (ABA) services, improving the future of the ABA experience for families by creating software and predictive algorithms that elevate clinicians to work smarter. We are working diligently to continuously improve the patient journey and deliver personalized care by applying smart technology and investing in the growth of our world-class team.

We are seeking a skilled Contracting and Credentialing Specialist to join our dynamic team. In this role, you will handle contracting and credentialing needs for our US-based health care providers, diagnostic laboratories, and medical facilities as preferred providers in healthcare networks.

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; 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.

Requirements:

  • 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 and be willing to adhere to company security practices.

Forta offers a collaborative work environment, opportunities for professional growth, and a chance to make a meaningful impact. If you are data-driven, detail-oriented, and capable of wearing multiple hats, we would love to have you on our team.

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