Credentialing Specialist(Provider Side)

3 days ago

Chennai, Tamil Nadu, India Anicut Healthcare Solutions Full time ₹ 9,00,000 - ₹ 12,00,000 per year

Job description

Credentialing Specialist(Provider Side)

We are looking for a Experienced Credentialing Specialist(Provider Side) to join our medical billing team for the Mid shift. The ideal candidate will have 1-4 years of experience in medical billing with a strong focus on Credentialing Process(Provider Side).

  • Job Role: Credentialing Enrollment(Provider Side)
  • Designation: Credentialing Specialist
  • Qualification: Any UG & PG Degree/Diploma
  • Exp:1-4 Years
  • Location: Okkiyampettai ,Thoripakkam, Chennai
  • Shift timings: Mid Shift (12:00 pm - 9:00 pm)
  • Working Days: Monday to Friday

Key Responsibilities:

  • Submit and track credentialing applications to insurance carriers and other healthcare payers.
  • Maintain accurate provider records and update information with insurance companies, including NPI, malpractice, and licensure data.
  • Communicate with insurance companies over the call and e-mails to resolve any issues or discrepancies in provider credentials.
  • Verify the accuracy and completeness of documentation submitted for credentialing and re-credentialing.
  • Ensure timely renewal of provider contracts with insurance companies and government payers (e.g., Medicare, Medicaid).
  • Act as a liaison between healthcare providers, insurance carriers, and internal teams to resolve credentialing issues.
  • Monitor and manage credentialing status for providers to ensure continued participation in insurance networks.
  • Ensure compliance with regulatory requirements for insurance credentialing and maintain current knowledge of industry best practices.
  • Maintain and update credentialing databases and systems.
  • Prepare reports on credentialing activities and status for management.

Qualifications:

  • 1-3 years of experience in insurance Credentialing (Provider Side) or healthcare administration.
  • Strong knowledge of insurance credentialing processes, including experience with Medicare, Medicaid, and commercial insurance plans.
  • Familiarity with the CAQH and National Provider Identifier (NPI) system, and related healthcare regulations.
  • No cab facility is provided, Candidates are required to arrange their own transportation.

Interested candidates please contact HR

(Interview days- Monday to Friday)

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