PLEASE DO NOT APPLY IF YOU DO NOT HAVE US HEALTHCARE CREDENTIALING EXPERIENCE

OMC is looking for a Delegated Credentialing Supervisor (Remote) to join our team! The Delegated Credentialing Specialist is responsible for organizing, maintaining, and verifying all aspects of the delegated credentialing process for General, Urgent care and Surgeons. In all activities, they must comply with all legal and regulatory policies and procedures. Minimum 3-5 years’ experience in Healthcare Credentialing required. This role will be to take on existing clients, get information uploaded to new credentialing software with a plan to expand sales for credentialing and subsequently expand the credentialing team under the guidance of the Supervisor.

Responsibilities:

1. Adhere to NCQA guidelines.

2. Audit Provider Licensure Files to NCQA guidelines.

3. Pull On-Going Files in accordance to NCQA.

4. Understanding of Initial and Re-Credential Delegated files.

5. Delegated Credentialing Payer Submissions.

6. Prepare and distribute facility and provider applications to payers.

7. Coordinate, monitor and maintain all credentialing and re-credentialing processes.

8. Upload and update the system with current documents.

9.



Ongoing interaction with payers.

10. Assist offices and internal departments with credentialing issues.

11. Must be able to utilize the licensure portals.

12. Source for effective dates from the payers.

13. Notify relevant parties of effective dates.

14. Keep records in licenses, credentials and insurance contracts.

15. Responsible for all insurance changes.

16. Respond to payers in a timely manner.

17. Responsible for tracking provider renewals.

18. Assess Monthly/Quarterly payer Directory updates.

19. Communication with providers as needed.

20. Other projects as assigned.

Qualifications:

1. Minimum 3-5 years’ experience in Healthcare Credentialing required.

2. Excellent verbal and written communication skills.

3. Well organized and detail-oriented with the ability to multi-task.

4. Proficiency with Microsoft Office products, including Word and Outlook required.

5. Must be able to function with minimal supervision and be able to prioritize all work tasks.

Job Type: Full-time

Pay: ₹60,000.00 - ₹80,000.00 per month

Work Location: Remote

📌 Credentialing Supervisor (India)
🏢 Officium Management
📍 India