Credentialing

As a Credentialing professional in Chennai, you will be responsible for collecting, reviewing, and verifying providers" education, training, licensure, certifications, and work history. Your role will involve ensuring compliance with state, federal, and organizational regulations. Additionally, you will be completing and submitting applications for provider enrollment with insurance networks, Medicare, Medicaid, and hospital privileges. It will be your duty to track application status, follow up on pending approvals, and maintain up-to-date provider information in credentialing databases and systems. You will play a crucial role in tracking expiration dates for licenses and certifications to ensure timely renewals. Acting as a liaison between providers, insurance networks, and regulatory agencies will be part of your responsibilities. Effective communication with physicians and healthcare staff regarding credentialing requirements and updates is essential. You will also address and resolve any discrepancies or delays in the credentialing processes and investigate providers" complaints related to credentialing and enrollment. The qualifications and requirements for this role include a minimum of 1 year of experience in credentialing. While a college degree is a plus, it is not mandatory. Preferred skills for this position involve having strong attention to detail and organizational skills, knowledge of credentialing software and databases such as CAQH and PECOS, familiarity with regulatory guidelines like CMS, NCQA, and Joint Commission, ability to work independently, meet deadlines, and effectively communicate with clients and internal billing departments to resolve issues. Your communication skills, especially in English, will play a vital role in this role. You are expected to have the ability to read and communicate effectively in English to carry out your responsibilities efficiently.,