Healthcare Provider Credentialing Specialist

1 week ago

Udaipur, Rajasthan, India beBeeCredentialing Full time ₹ 9,00,000 - ₹ 12,00,000

Role Overview:

We are seeking an experienced professional with a strong background in provider enrollments, insurance credentialing, and re-credentialing. The ideal candidate will thrive in a fast-paced environment where attention to detail and ability to complete tasks within set deadlines is essential.

Key Responsibilities:

  • Manage end-to-end provider credentialing and enrollment processes including filing Letters of Interest and completing enrollment applications for all states.
  • Engage with payers via calls and emails to ensure successful processing of both individual and group applications.
  • Demonstrate expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, Medicaid MCO, and Medicare supplement/replacement plans.
  • Maintain regular communication with clients providing updates and ensuring active status of providers with payers.
  • Handle end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES, and other provider portals.
  • Manage application and renewal process for all provider licenses including Professional, DEA, and Controlled Substance licenses.
  • Ensure continuous updating and maintenance of client and application data readily available for client requests.

Requirements:

  • A minimum of 5 years 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.

Essential Skills:

  • Strong understanding of healthcare regulations and policies.
  • Excellent problem-solving and analytical skills.
  • Ability to multitask and prioritize tasks effectively.
  • Proficient in MS Office and credentialing software.
  • Strong written and verbal communication skills.

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