Credentialing SpecialistConfidential • Bengaluru / Bangalore, India
Credentialing Specialist
Confidential • Bengaluru / Bangalore, India
28 days ago
Job descriptionMaintain individual provider files and group information to include up to date information needed to complete the required government and commercial payer credentialing applications. Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. Collect and maintain files in relation to credentialing of network providers including current provider licenses, DEA certificates, malpractice insurance, board certifications, and other pertinent forms need for enrolment Maintain internal trackers to ensure all information is accurate and logins are available and legible Update each provider's CAQH database file timely according to the schedule published by CMS Complete revalidation requests issued by government payers
Role -
Credentialing Specialist / Analyst will be responsible for meeting the set SLAs, viz, productivity, quality and attendance.
Requirements -
- Education : Graduates / Diploma holders
- Knowledge : US Medical billing, provider credentialing
- Experience : 1 to 2 years for Analyst and 3 years – 5 years for specialist
- Knowledge of provider credentialing and contracting with government and commercial Insurance plans
- Minimum 1 year of experience in submitting applications for contracting and credentialing with Insurance plans
- Excellent computer skills including Excel, Word, and Internet use
- Plans and priorities to meet deadlines.
Key Responsibilities -
Skills Required
Word, Excel
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Specialist • Bengaluru / Bangalore, India
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