Credentialing
4 hours ago
Full Job Description
**Summary**:
The Credentialing Specialist, is accountable for leading and overseeing the collection of provider data and information to support the organization's credentialing and payer enrollment operations.
**Essential Duties and Responsibilities**:
- Develop credentialing processes and procedures, overseeing day-to-day implementation.
- Monitors process, and document all provider licenses and renewals, as well as credentialing for all state Medicaid and health plans accurately and in a timely manner prior to expiration.
- Monitor credentialing & licensing statuses for all licensed clinical providers, tracking re-credentialing requirements and creating new workflows as needed.
- Research and document required licenses and credentialing for company.
- Assist in resolving licensing and credentialing issues as needed.
- Maintain current and appropriate knowledge of provider licensing practices and Medicaid deadlines.
- Research and track state licensing and supervisory requirements for all states in which our company does business (MD, NP, PA, and PT)
- Track: CME requirements, supervisory agreements and regulations, licensure renewal and status, network status for providers
- Overseeing the completion of:
- CLIA and business certifications,
- TIN and set up,
- Medicare number acquisition, and
- Provider CAQH ProView profile
- Provide project management support to care team leadership on related projects.
- Responsible and accountable for maintaining compliance with all contractual obligations, state regulations and NCQA standards for activities related to the areas of responsibility.
Knowledge, Skills, and Abilities:
- Knowledge and understanding of local, state, federal laws and regulations pertaining to guidelines from Medicaid.
- Ability to document and analyze complex business requirements and
- Ability to manage complex projects and catalyze and energize teams with clear plans, accountabilities, and teamwork to efficiently execute.
- Ability to interface with Senior Level Executives during client meetings
- Must be a proactive, hands-on leader with a proven strategic vision who will drive operational performance with a high degree of accountability and integrity.
- Strong financial & data acumen - detail orientated, precision & proven track record managing budgets.
- Ability to be both a strategic and tactical change agent in the healthcare
- Self-starter who will take initiative and be proactive
- Strong interpersonal skills and ability to communicate
- Ability to create compelling and dynamic presentations.
- Ability to handle ambiguity and desire to work in a fast-paced start-up.
Pay: ₹25,000.00 - ₹40,000.00 per month
**Benefits**:
- Food provided
- Health insurance
- Paid sick time
- Paid time off
- Provident Fund
Schedule:
- Monday to Friday
- Weekend availability
Ability to commute/relocate:
- Sahibzada Ajit Singh Nagar, Punjab, Mohali - 160071, Punjab: Reliably commute or planning to relocate before starting work (required)
**Experience**:
- total work: 1 year (preferred)
**Language**:
- English (preferred)
Shift availability:
- Day Shift (preferred)
**Speak with the employer**
+91 8054125057
-
Credentialing SME
4 days ago
Sahibzada Ajit Singh Nagar, India Nath Outsourcing Solutions Pvt. Ltd. Full timeCredentialing SME About the Company: Established in 2003, Nath Outsourcing Solutions Pvt. Ltd. (NOS) specializes in end-to-end solutions for the US Healthcare Industry . Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding of Revenue Cycle Management (RCM) concepts. With a team...
-
Credentialing SME
5 days ago
Sahibzada Ajit Singh Nagar, India Nath Outsourcing Solutions Pvt. Ltd. Full timeCredentialing SME About the Company: Established in 2003, Nath Outsourcing Solutions Pvt. Ltd. (NOS) specializes in end-to-end solutions for the US Healthcare Industry. Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding of Revenue Cycle Management (RCM) concepts. With a team of...
-
Credentialing SME
5 days ago
Sahibzada Ajit Singh Nagar, India Nath Outsourcing Solutions Pvt. Ltd. Full timeCredentialing SME About the Company:Established in 2003,Nath Outsourcing Solutions Pvt. Ltd. (NOS)specializes in end-to-end solutions for theUS Healthcare Industry. Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding ofRevenue Cycle Management (RCM)concepts. With a team of...
-
Credentialing SME
5 days ago
Sahibzada Ajit Singh Nagar, India Nath Outsourcing Solutions Pvt. Ltd. Full timeEstablished in 2003, Nath Outsourcing Solutions Pvt. NOS) specializes in end-to-end solutions for the US Healthcare Industry . Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding of Revenue Cycle Management (RCM) concepts. With a team of highly skilled professionals, we are...
-
Manager - Provider Enrollment & Credentialing
22 hours ago
Sahibzada Ajit Singh Nagar, India Knack RCM Full timeAbout the Role:The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers.This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client...
-
Sahibzada Ajit Singh Nagar, India Knack RCM Full timeAbout the Role:The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers.This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client...
-
Sahibzada Ajit Singh Nagar, India Knack RCM Full timeAbout the Role: The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers. This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client...
-
Manager - Provider Enrollment & Credentialing
19 hours ago
Sahibzada Ajit Singh Nagar, India Knack RCM Full timeAbout the Role: The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers. This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client...
-
S.A.S Nagar, India Knack RCM Full timeAbout the Role: The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers. This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client...
-
Assistant Professor/Associate Professor- CSE
4 weeks ago
Sahibzada Ajit Singh Nagar, India Chandigarh University Full timeJob Title:Assistant Professor / Associate Professor / Professor – Computer Science & EngineeringLocation:Chandigarh University, Gharuan, Mohali, Punjab, IndiaQualifications (Mandatory):B.Tech in Computer Science or relevant discipline from a recognized universityM.Tech in Computer Science or related specializationPh.D. in Computer Science / Computer...
