Part Time English Specialist

1 day ago

Gurgaon, India WNS Full time

About the Company WNS (Holdings) Limited (NYSE: WNS) is a digital-led business transformation and services company. WNS combines deep domain expertise with talent, technology, and AI to co-create innovative solutions for over 700 clients across various industries. WNS delivers an entire spectrum of solutions including industry-specific offerings, customer experience services, finance and accounting, human resources, procurement, and research and analytics to re-imagine the digital future of businesses. As of June 30, 2025, WNS had 66,085 professionals across 65 delivery centers worldwide including facilities in Canada, China, Costa Rica, India, Malaysia, the Philippines, Poland, Romania, South Africa, Sri Lanka, Turkey, the United Kingdom, and the United States. About the Role - Credentialing Specialist (US Healthcare) S. healthcare providers in the dental care space for in-network preferred providers. Ensure providers meet all internal and external regulatory requirements, payer standards, and accreditation guidelines. Maintain accurate provider files, coordinate with insurance payers, and support compliance and quality initiatives. Verify provider credentials including education, training, licensure, board certification, work history, malpractice history, and references. Maintain and update provider data in credentialing databases (e.g., Ensure compliance with regulatory, accreditation, and payer requirements including NCQA, CMS, Joint Commission, and state agencies. Prepare and present completed files for Credentialing Committee and Medical Executive Committee review. Maintain confidentiality of provider information in accordance with HIPAA and organizational policies. Assist in developing and updating credentialing policies and procedures. Participate in audits and quality improvement initiatives as assigned. Demonstrate hands-on experience in federal and commercial payer application submissions including Medicaid, Medicare, and commercial payers. Check Deal Log bi-weekly for new office opening dates. Confirm Owner/Billing Provider with the VP of Operations. Verify current credentials on file for the Owner/Billing Provider. Request NPI Type 2 (Billing Entity NPI). Complete applications and contracts for the Billing Provider and submit for signatures. Submit completed paperwork within 24 hours to applicable plans for approval and network acceptance. Follow up with dental plans. Process billing changes (ownership changes, PC changes, TIN changes). Credential owners, associates, and specialists as required. Ensure compliance with company policies and with state, federal, and other regulatory bodies. Qualifications - Any Graduate Experience - Minimum 2 year Preferred Experience - Dental credentialing Work Mode - Work from Office Shifts - 24*7 Night Rotational Shifts , 2 Days Rotational Offs Note: Only Immediate Joiners are required.

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