Healthcare Credentialing Specialist

2 days ago

Vadodara, Gujarat, India beBeeCredentialing Full time ₹ 8,00,000 - ₹ 10,00,000

We are seeking a detail-oriented professional to manage the provider enrollment process. 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:
  • Demonstrate 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.
  • Ensure timely and efficient submission of all completed applications to relevant entities.
  • Track application statuses and proactively follow up on outstanding items to expedite approval.
  • Welcome Kit Generation & Contract Loading:
  • Create and disseminate comprehensive Welcome Kits for new providers, ensuring all necessary documentation and information is included.
  • Accurately and efficiently load provider contracts into the designated system, ensuring all terms and conditions are correctly captured.
  • Application Portal Expertise:
  • Experience in creating and managing accounts within key healthcare application portals, including:
  • CAQH (Council for Affordable Quality Healthcare): Establish provider profiles for efficient data sharing.
  • Medicaid: Navigate state-specific Medicaid enrollment processes.
  • Medicare (PECOS portal): Submit and manage Medicare enrollment applications through the Provider Enrollment, Chain and Ownership System.
  • NPI (National Provider Identifier): Assist providers in obtaining and managing their NPI numbers.
  • Regional Credentialing Advantage:
  • Working with providers specifically in Florida will be considered an advantage, demonstrating familiarity with state-specific regulations and payer requirements.
  • Communication & Responsiveness:
  • Maintain a high level of professionalism and responsiveness in all email communications, promptly addressing queries and providing clear, concise information to internal and external stakeholders.
  • Compliance & Confidentiality:
  • Adhere to all HIPAA regulations and maintain the utmost confidentiality of sensitive patient and provider information.
  • Ensure all credentialing activities are in full compliance with federal, state, and organizational guidelines.

Skill Sets:

  • Excellent communication and interpersonal skills, conveying information clearly, concisely, and effectively both verbally and in writing.
  • Ability to work independently and as part of a team, exhibiting a strong sense of initiative and self-motivation, capable of managing tasks and responsibilities autonomously with minimal supervision.
  • Proficiency in Google Sheets and Docs, highly skilled in utilizing Google Sheets for data organization, analysis, and visualization, including complex formulas, pivot tables, and charts.
  • Excellent typing skills, possessing a high level of accuracy and speed in typing, significantly contributing to efficient data entry, document creation, and overall productivity.
  • Comprehensive knowledge of computer usage and navigation, displaying a thorough understanding of operating systems, common software applications, and internet browsers.

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