Tl-provider Credentialing

2 days 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 with internal teams to streamline the credentialing workflow and improve efficiency.
- Provide guidance and support to providers throughout the credentialing process.
- Develop and implement strategies to enhance the credentialing process and reduce turnaround times.
- Ensure adherence to all regulatory requirements and organizational policies related to credentialing.
- Conduct regular audits of credentialing files to maintain data integrity and compliance.
- Communicate effectively with providers and stakeholders to address any credentialing-related inquiries or issues.
- Utilize healthcare product knowledge to optimize credentialing procedures and outcomes.
- Contribute to the development of best practices and standard operating procedures for credentialing.
- Support the revenue cycle management team by ensuring accurate provider information is available for billing and claims processing.

**Qualifications**
- Demonstrate expertise in revenue cycle management with a focus on credentialing and re-credentialing.
- Exhibit excellent communication and interpersonal skills to interact with providers and stakeholders.
- Show proficiency in data analysis and verification to maintain accurate provider records.
- Have experience in developing and implementing process improvement strategies.
- Display knowledge of regulatory requirements and industry standards for credentialing.
- Be capable of conducting audits and maintaining data integrity in credentialing files.

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