28 Oct
|
3D Solutions
|
Sahibzada Ajit Singh Nagar
28 Oct
3D Solutions
Sahibzada Ajit Singh Nagar
Key Responsibilities
- Manage end-to-end provider credentialing, re-credentialing, and payer enrollment processes.
- Collect, verify, and maintain accurate provider data including licenses, certifications, DEA, NPI, malpractice insurance, and work history.
- Submit and follow up on applications with insurance payers, hospitals, and healthcare networks.
- Ensure compliance with NCQA, JCAHO, CMS, and state/federal regulations.
- Maintain credentialing records in credentialing systems and provider databases.
- Track credential expiration dates and proactively manage renewals.
- Coordinate with providers, payers, internal teams, and hospital staff to resolve credentialing issues.
- Audit credentialing files regularly to ensure accuracy and completeness.
- Prepare reports and documentation for audits and internal reviews.
- Support onboarding of new providers by completing credentialing within defined timelines.
Required Qualifications
- 1 to 2 years of experience as a Credentialing Specialist or in a similar healthcare credentialing role.
- Strong knowledge of provider credentialing, payer enrollment, and medical staff regulations.
- Experience working with commercial payers, Medicare, and Medicaid.
- Familiarity with credentialing software and CAQH ProView.
- Excellent organizational and documentation skills.
- Ability to manage multiple providers and deadlines simultaneously.
- Strong written and verbal communication skills.
Fresher can also apply for this profile.
Interested candidates, kindly share resume at
[email protected] or call/whatsApp at +91-XXXXXXXXXX
Pay: ₹18,000.00 - ₹25,000.00 per month
Advantages:
- Provident Fund
Work Location: In person
📌 Junior Process Associate - Credentialing (Medical Billing/RCM) (Sahibzada Ajit Singh Nagar)
🏢 3D Solutions
📍 Sahibzada Ajit Singh Nagar