Healthcare Credentialing Expert

Medical Provider Enrolment Professional

We are seeking experienced Medical Provider Enrolment Specialists with a strong background in end-to-end provider enrolments, insurance credentialing and contract management.

Main Responsibilities :

• Manage the full spectrum of provider credentialing and enrolment including filing letters of interest and completing applications for all states.
• Engage with payers via calls and emails to ensure successful processing of individual and group applications.
• Demonstrate expertise in submitting required documentation for private commercial payors, Medicare, Medicaid, MCO and Medicare supplement / replacement plans.
• Maintain regular communication with clients providing updates and ensuring active status of providers with payers.
• Handle end-to-end processes for creating and maintaining provider details on platforms such as CAQH, PECOS, Availity, Navinet, NPPES and other provider portals.
• Manage application and renewal process for all provider licenses including Professional DEA and Controlled Substance licenses.
• Ensure continuous updating and maintenance of client and application data readily available for client requests.

Requirements :