Credentialing Specialist I Vadodara, India

1 week ago

Vadodara, India Qualifacts Systems Inc Full time

Description

Responsibilities: - Coordinate and manage the credentialing and re-credentialing process for healthcare providers, including physicians, nurses, therapists, and other allied health professionals.- Collect and review provider credentialing applications, ensuring accuracy and completeness of information.- Verify provider credentials, including education, training, licensure, certifications, and professional experience, through primary sources and credentialing databases.- Communicate with healthcare providers, licensing boards, professional organizations, and insurance carriers to obtain necessary documentation and resolve credentialing issues.- Maintain accurate and up-to-date provider credentialing files and databases, ensuring compliance with regulatory standards and accreditation requirements.- Monitor and track credentialing status and expirations, initiating re-credentialing processes as needed to maintain provider network participation.- Collaborate with internal departments, including billing, compliance, and human resources, to ensure timely credentialing and enrollment of providers. Qualifications: - Bachelor's degree in healthcare administration, business administration, or related field preferred.- Minimum of 0-2 years of experience in credentialing and provider enrollment, preferably in a healthcare or RCMS setting.- Proficiency in credentialing software and databases, such as CAQH, NPPES , and payer-specific enrollment portals is a plus.- Excellent organizational skills and attention to detail, with the ability to manage multiple priorities and meet deadlines in a fast-paced environment.- Effective communication and interpersonal skills, with the ability to collaborate with internal and external stakeholders.- Knowledge of medical terminology, healthcare billing, and reimbursement processes is a plus.If you are a motivated professional with experience in credentialing and provider enrollment, we invite you to apply for the Credentialing Specialist position and join our dynamic team in the RCMS industry. Location: -Vadodara, Gujarat (work from office only) Timings:- Night Shift.

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