Job Description:

BASIC PURPOSE:

Responsible for processing internal applications for membership with our staffing company. This role ensures that all applications meet company standards and underwriting requirements.

ESSENTIAL FUNCTIONS:
- Coordinate verification and risk assessment processes using NCQA, the Joint Commission, and other appropriate standards as outlined in company policies.
- Process clinical candidate applications, including underwriting facilitation.
- Evaluate completed provider applications by systematically comparing applicant-reported data with primary source verifications and internal credentialing standards.
- Identify and investigate discrepancies, document findings, and coordinate with appropriate parties to resolve issues before Risk Review.
- Credentials verifications on initial applications and reapplications of clinical candidates, including extended verifications as needed by internal and/or external clients.
- Assessment of risk for clinical candidates to underwrite them for malpractice insurance.




- Data entry and data integrity of the provider within the credentialing system and company database.
- Liaison to providers as point person for completion and delivery of required information promptly.
- Assist in the ongoing documentation of internal credentialing processes while seeking out opportunities to improve these procedures.
- Other duties as assigned.
- Must have the ability to perform the essential functions of the job with or without reasonable accommodation.

REPORTING RELATIONSHIPS:
- This position does not have any direct reports.

QUALIFICATIONS:
- Minimum of 1 year of experience in healthcare credentialing, medical staff services, or a related field.
- Experience with provider credentialing, underwriting, or healthcare staffing credentialing is preferred.
- Preferred: Certified Provider Credentialing Specialist (CPCS) certification or ability to obtain this certification within the first 2 years in the role.
- Proficien

📌 Credentialing (Pune)
🏢 HigHRise Solutions
📍 Pune