Credentialing Specialist

2 months ago

Ahmedabad, India LETS ENKINDLE SOFTSERV PRIVATE LIMITED Full time

Credentialing Specialist

 

Job Overview:

We are seeking a highly organized and detail-oriented Credentialing Specialist with specialized knowledge in Medicaid and Managed Care Organizations (MCOs). The Credentialing Specialist will be responsible for managing and processing credentialing documentation for healthcare providers, ensuring compliance with state and federal regulations. This role requires expertise in Medicaid regulations, MCO credentialing processes, and familiarity with Medicare credentialing. The ideal candidate will have 1-3 years of experience, exhibit exceptional attention to detail, and be able to manage credentialing documentation with accuracy.

Key Responsibilities:

  • Medicaid and MCO Credentialing:
    • Manage the credentialing and re-credentialing process for healthcare providers, ensuring compliance with Medicaid regulations and MCO requirements.
    • Collect, verify, and process credentialing documentation for providers.
    • Maintain up-to-date knowledge of MCO policies and Medicaid credentialing requirements.
  • Medicare Credentialing:
    • Oversee the Medicare credentialing process for healthcare providers, ensuring adherence to federal guidelines.
    • Ensure providers meet all necessary qualifications for Medicare participation.
  • Regulatory Compliance:
    • Stay updated on relevant Medicaid, MCO, and Medicare regulations and guidelines.
    • Ensure compliance with state and federal laws governing credentialing processes.
  • Documentation Management:
    • Collect, review, and accurately maintain credentialing documentation, including licenses, certifications, and background checks.
    • Track credentialing timelines, ensuring timely renewals of provider credentials and licenses.
    • Ensure documentation is audit-ready and compliant with all regulatory requirements.
  • Communication & Collaboration:
    • Work closely with internal teams and external stakeholders to ensure a smooth credentialing workflow.
    • Serve as the primary point of contact for inquiries related to credentialing.
  • Data Management:
    • Use credentialing software to manage, update, and track provider credentialing data.
    • Conduct regular audits of credentialing files to maintain data accuracy.

 

Qualifications:

Associate's or Bachelor's degree in healthcare administration, business administration, or a related field preferred.

Skills:

  • Strong understanding of Medicaid regulations and MCO credentialing requirements.
  • Knowledge of Medicare credentialing processes.
  • Attention to detail and excellent organizational skills.
  • Strong written and verbal communication skills.
  • Ability to handle multiple tasks and meet deadlines.
  • Proficiency in credentialing software and systems.

 

 

  • Credentialing Specialist

    3 weeks ago

    ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job description Overview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information....

  • Credentialing specialist

    3 weeks ago

    Ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job descriptionOverview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information. This...

  • Credentialing Specialist

    3 weeks ago

    Ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job descriptionOverview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information. This...

  • Credentialing Specialist

    3 weeks ago

    Ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job descriptionOverview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information. This...

  • Credentialing Specialist

    3 weeks ago

    Ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job description Overview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information....

  • Credentialing Specialist

    3 weeks ago

    Ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job description Overview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information....

  • Intelligent Medical Billing Solutions | Credentialing Specialist | ahmedabad

    3 weeks ago

    ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job descriptionOverview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information. This...

  • Intelligent Medical Billing Solutions | Credentialing Specialist | ahmedabad

    3 weeks ago

    ahmedabad, India Intelligent Medical Billing Solutions Full time

    Job descriptionOverview: We are seeking a highly detail-oriented and organized credentialing specialist to join our medical billing team. The ideal candidate will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with regulatory requirements, and maintaining accurate and up-to-date provider information. This...

  • "credentialing specialist"

    2 weeks ago

    Ahmedabad, India Aqkode Healthcare Services & Solutions Full time

    Require a minimum 6 months to 1 year of experience.Required good communication skills (Both written and verbal)Working knowledge of the current basics of Microsoft Office.Prioritization and multi-task skills are required.Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.Set up and maintain CAQH/PECOS; maintain all...

  • "Credentialing Specialist"

    2 weeks ago

    Ahmedabad, India Aqkode Healthcare Services & Solutions Full time

    Require a minimum 6 months to 1 year of experience.Required good communication skills (Both written and verbal)Working knowledge of the current basics of Microsoft Office.Prioritization and multi-task skills are required.Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.Set up and maintain CAQH/PECOS; maintain all...

  • "Credentialing Specialist"

    2 weeks ago

    Ahmedabad, India Aqkode Healthcare Services & Solutions Full time

    Require a minimum 6 months to 1 year of experience.Required good communication skills (Both written and verbal)Working knowledge of the current basics of Microsoft Office.Prioritization and multi-task skills are required.Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.Set up and maintain CAQH/PECOS; maintain all...

  • "Credentialing Specialist"

    2 weeks ago

    Ahmedabad, India Aqkode Healthcare Services & Solutions Full time

    Require a minimum 6 months to 1 year of experience.Required good communication skills (Both written and verbal)Working knowledge of the current basics of Microsoft Office.Prioritization and multi-task skills are required.Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.Set up and maintain CAQH/PECOS; maintain all...

  • Aqkode Healthcare Services

    2 weeks ago

    ahmedabad, India Aqkode Healthcare Services & Solutions Full time

    Require a minimum 6 months to 1 year of experience.Required good communication skills (Both written and verbal)Working knowledge of the current basics of Microsoft Office.Prioritization and multi-task skills are required.Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.Set up and maintain CAQH/PECOS; maintain all...

  • Social Media Marketing Lead

    1 week ago

    Ahmedabad, Gujarat, India MapMyBusiness Full time

    We are looking for a highly skilled social media marketing lead to oversee our company's presence on various public platforms.About MapMyBusinessMapMyBusiness is a dynamic organization seeking talented professionals to join our team. We offer competitive compensation and benefits packages.Job Description:The social media marketing lead will be responsible...

  • Social Media Executive

    5 months ago

    Ahmedabad, India Inevitable Infotech Pvt. Ltd. : Work From Anywhere Full time

    Social Media Executive Responsibilities: Training and supervising a cohort of social media specialists. Creating written pieces that are sharp, memorable, and effective at prompting readers to take action. Collaborating with Videographers and Multimedia Designers to ensure that posts are engaging. Optimizing content for publication across various social...

  • Social Media Executive

    7 months ago

    Ahmedabad, India MapMyBusiness Full time

    We are looking for a witty and strategic social media executive to oversee our company's presence on a multitude of public platforms.Responsibilities:Training and supervising a cohort of social media specialists.Creating written pieces that are sharp, memorable, and effective at prompting readers to take action.Collaborating with Videographers and Multimedia...

  • Social Media Marketing Executive

    6 months ago

    Ahmedabad, Gujarat, India TALENT HUB HR SOLUTION Full time

    Training and supervising a cohort of social media specialists. - Creating written pieces that are sharp, memorable, and effective at prompting readers to take action. - Collaborating with Videographers and Multimedia Designers to ensure that posts are engaging. - Optimizing content for publication across various social media sites. - Scheduling copy for...

  • Tender Executive

    3 months ago

    Ahmedabad, Gujarat, India E-Procurement Technologies Limited Full time

    We are hiring **Tender bidding specialist** **Job Location**:Ahmedabad **Experience: 1-3 years** **Major Requirements: - ** * (1) **Other Than GeM Portals like ,(i.e BHEL, IREPS, BPCL, IOCL, N-Procure ,All NIC States Procurement Portals etc.for CPPP, - Registration & Bidding Support Both )** (2) Vendor Assessment / OEM Panel Through RITES portal (3)...

  • Digital Media Strategist

    1 month ago

    Ahmedabad, Gujarat, India MapMyBusiness Full time

    Job Title: Social Media ExecutiveAbout the Role:We are seeking a highly skilled Social Media Executive to lead our company's online presence. As a key member of our team, you will be responsible for developing and implementing a comprehensive social media strategy to engage our audience and drive business growth.Key Responsibilities:* Train and supervise a...

  • Cyber Security Sales Specialist

    1 month ago

    Ahmedabad, Gujarat, India Cyber Info Electronic Security System Pvt. Ltd. Full time

    We are looking for a highly motivated and experienced Sales Engineer to join our team at Cyber Info Electronic Security System Pvt. Ltd.About the RoleThe ideal candidate will have a strong background in technical sales and be able to identify and pursue new business opportunities.Key ResponsibilitiesIdentify and Pursue New Business Opportunities: Find and...