Spe-provider Credentialing

4 days ago

Hyderabad Telangana, India Cognizant Full time

**Job Summary**

Join our dynamic team as a Specialist in Provider Credentialing where you will leverage your expertise in healthcare products and credentialing processes to ensure compliance and efficiency. With 4 to 6 years of experience you will play a crucial role in maintaining the integrity of our provider network. This hybrid role offers the flexibility of night shifts allowing you to balance work and personal commitments effectively.

**Responsibilities**
- Oversee the credentialing and re-credentialing processes for healthcare providers to ensure compliance with industry standards and regulations.
- Collaborate with cross-functional teams to streamline credentialing workflows and improve operational efficiency.
- Analyze provider data to identify discrepancies and implement corrective actions to maintain data accuracy.
- Develop and maintain comprehensive documentation of credentialing procedures and policies.
- Provide support and guidance to providers throughout the credentialing process to ensure a smooth and efficient experience.
- Monitor and report on credentialing metrics to identify trends and areas for improvement.
- Implement best practices in credentialing to enhance the quality and reliability of provider information.
- Coordinate with external agencies and stakeholders to facilitate timely credentialing approvals.
- Utilize healthcare product knowledge to optimize credentialing processes and ensure alignment with organizational goals.
- Conduct regular audits of credentialing files to ensure compliance with internal and external standards.
- Assist in the development and delivery of training programs for new team members on credentialing procedures.
- Participate in continuous improvement initiatives to enhance the overall effectiveness of the credentialing department.
- Ensure all credentialing activities are conducted in accordance with company policies and regulatory requirements.

**Qualifications**
- Demonstrate expertise in credentialing and re-credentialing within the healthcare domain.
- Exhibit excellent analytical skills to assess provider data and identify discrepancies.
- Show proficiency in developing and maintaining documentation of credentialing procedures.
- Display strong communication skills to support providers and collaborate with cross-functional teams.
- Have experience in monitoring and reporting on credentialing metrics.
- Be adept at coordinating with external agencies for credentialing approvals.

**Certifications Required**

Certified Provider Credentialing Specialist (CPCS)

  • SPE/Team Lead/QA-Credentialing voice

    10 hours ago

    Bengaluru, Hyderabad, India Nexwave Talent Management Solutions Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Role & responsibilitiesPreferred candidate profileHirings for SPE-Credentialing/SME-QA Credentialing/Team Lead- Credentialing.Experience required: 2-8+ years credentialing voice is mustGood communication skillsFlexible to work with US shiftsMode: WFHWork location: Chennai/Hyderabad/BangaloreAny GraduatesHirings on Team Lead and QA-Credentialing voice

  • Tl-provider Credentialing

    1 week ago

    Hyderabad, Telangana, India Cognizant Full time

    **Job Summary** **Responsibilities** - Oversee the provider credentialing process to ensure compliance with industry standards and regulations. - Coordinate with healthcare providers to gather necessary documentation for credentialing and re-credentialing. - Analyze and verify provider information to maintain accurate and up-to-date records. - Collaborate...

  • TL-Provider Credentialing

    1 week ago

    Hyderabad, Telangana, India Cognizant Technology Solutions Full time ₹ 15,00,000 - ₹ 25,00,000 per year

    Job SummaryWe are seeking a dedicated professional for the role of TL-Provider Credentialing with 6 to 8 years of experience. The ideal candidate will have expertise in HealthCare Products and a strong background in Revenue Cycle Management Credentialing and Re-credentialing. This hybrid role requires working night shifts and offers an opportunity to make a...

  • Provider Credentialing

    2 weeks ago

    Chennai, Hyderabad, India Thryve Digital Full time ₹ 5,00,000 - ₹ 12,00,000 per year

    Role Summary:This job takes the lead in providing effective team handling and timely delivery of assigned task and required a strong knowledge in denial management, Trend analysis and should be an expert in reports management and process analytics and a proven job knowledge in Hospital Billing.JOB SUMMARYThis job gives an opportunity to work in a challenging...

  • Credentialing Executive

    18 hours ago

    Hyderabad, Telangana, India Harmony United Medsolutions Pvt.Ltd Full time

    **Job Title**: Credentialing Executive **Location**: Hyderabad, Telangana **Company**: Harmony United Medsolutions Pvt. Ltd. **About Us**: **Position Overview**: The Credentialing Executive will be responsible for managing the credentialing and re-credentialing processes for psychiatric care providers within our network. The role will also focus on...

  • Credentialing Fresher

    4 weeks ago

    Hyderabad, Telangana, India Harmony United Psychiatric Care Full time

    Job Title Credentialing Fresher Location Hyderabad Telangana Company Harmony United Medsolutions Pvt Ltd About Us Harmony United Medsolutions Pvt Ltd HUMS is a dynamic and innovative company dedicated to revolutionizing the Healthcare Industry We at HUMS take pride in being a reliable partner as a Healthcare Management Company With nine years...

  • Credentialing Fresher

    6 days ago

    Hyderabad, Telangana, India Harmony United Psychiatric Care Full time

    **Job Title**: Credentialing Fresher **Location**: Hyderabad, Telangana **Company**: Harmony United Medsolutions Pvt. Ltd. **About Us**: **Position Overview**: The Credentialing Fresher will be responsible for managing the credentialing and re-credentialing processes for psychiatric care providers within our network. The role will also focus on maintaining...

  • Credentialing Executive

    2 weeks ago

    Tolichowki, Hyderabad, Telangana, India Harmony United Psychiatric Care Full time

    **Job Title**: Credentialing Executive **Location**: Hyderabad, Telangana **Company**: Harmony United Medsolutions Pvt. Ltd. **About Us**: **Position Overview**: The Credentialing Executive will be responsible for managing the credentialing and re-credentialing processes for psychiatric care providers within our network. The role will also focus on...

  • Credentialing Executive

    6 days ago

    Tolichowki, Hyderabad, Telangana, India Harmony United Psychiatric Care Full time

    **Job Title**: Credentialing Executive **Location**: Hyderabad, Telangana **Company**: Harmony United Medsolutions Pvt. Ltd. **About Us**: **Position Overview**: The Credentialing Executive will be responsible for managing the credentialing and re-credentialing processes for psychiatric care providers within our network. The role will also focus on...

  • SME- Provider Credentialing Voice

    2 days ago

    Chennai, Hyderabad, Pune, India Nexwave Talent Management Solutions Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Role & responsibilitiesPreferred candidate profileHiring- Provider CredentialingExperience: 4-6 yearsVoice ProcessExcellent communication skillsWFHLocation: Pan IndiaFlexible to work US shiftsNotice: Immediate-30 days max