TL-Provider Credentialing

6 days ago

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

Job Summary

We 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 significant impact on our healthcare operations.

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.
  • Monitor and track credentialing applications to ensure timely completion and approval.
  • 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

  • Possess a strong understanding of healthcare products and their application in credentialing processes.
  • 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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