910 Credentialing Jobs - Page 2

This job is with Organon, an inclusive employer and a member of myGwork – the largest global platform for the LGBTQ+ business community. Please do not contact the recruiter directly. Responsibilities Job Description Order to Cash (OtC) Management OtC Cycle Oversight: Manage the entire Order to Cash cycle, including customer order management, execution, and ensuring timely delivery of products to customers. Alliance Partners and SCM Governance: Collaborate with alliance partners to establish and maintain effective supply chain governance, ensuring compliance and alignment with strategic goals. Order Management: Coordinate order processing for all market customers, ensuring compliance with commercial and quality guidelines/SOPs. Inventory Control: Monitor inventory levels across super distributors (SDs) to prevent obsolescence and ensure product availability aligns with forecasts. Timely Shipment Delivery: Process, monitor, and deliver shipments to respective SDs/customers in a timely manner, maintaining high service levels (On-Time In-Full, Line-Item Fill Rate). Compliance Assurance: Ensure adherence to standard operating procedures (SOPs) and company policies throughout the OtC process, Including all ERP (Athena) transactions. Planning Process Management Demand Planning: Oversee demand planning for India and neighboring markets, ensuring accurate forecasts that align with business objectives. Fulfillment Planning: Manage fulfillment planning for local source supplies & review import supplies, optimizing supply chain efficiency. MRP Cycle Monitoring: Review the Material Requirements Planning (MRP) cycle, communicating net requirements to the respective import teams. Supply Chain Execution Management: Drive initiatives to monitor plan versus actuals, addressing chronic supply issues and updating stakeholders on constraints and potential sales losses. Collaboration with Regulatory : Collaborate with regulatory team to identify impacts on planning & supplies due to regulatory changes. Product Availability Monitoring: Ensure product availability aligns with forecasts at hubs. SD Management : Ensure product availability at Super distributors. Manage inventory across SDs while controlling inventory obsolescence. Key Deliverables Cost to Serve: Monitor and optimize the cost to serve metrics. Inventory Management: Analyze inventory norms based on product contributions and support improvements in inventory planning. Service Levels: Maintain high service levels and ensure compliance metrics are met. Forecast accuracy , On-Time In-Full, Line-Item Fill Rate) Relationship Management Organizational Development: Build and lead a highly effective supply chain organization capable of cross-functional collaboration. Stakeholder Engagement: Cultivate strong relationships with internal and external stakeholders to continuously understand and meet customer requirements. Required Education, Experience And Skills Graduate in Engineering or Supply Chain-related fields. A Master's degree is an added advantage. Experience in Supply Chain (Order to Cash, Planning Process, and Alliance Management). SAP experience 2-8 years - MM Module Secondary Job Description Who We Are: Organon delivers ingenious health solutions that enable people to live their best lives. We are a $6.5 billion global healthcare company focused on making a world of difference for women, their families and the communities they care for. We have an important portfolio and are growing it by investing in the unmet needs of Women's Health, expanding access to leading biosimilars and touching lives with a diverse and trusted portfolio of health solutions. Our Vision is clear: A better and healthier every day for every woman. As an equal opportunity employer, we welcome applications from candidates with a diverse background. We are committed to creating an inclusive environment for all our applicants. Search Firm Representatives Please Read Carefully Organon LLC, does not accept unsolicited assistance from search firms for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails. Annualized Salary Range Annualized Salary Range (Global) Annualized Salary Range (Canada) Please Note: Pay ranges are specific to local market and therefore vary from country to country. Employee Status Regular Relocation: No relocation VISA Sponsorship Travel Requirements: Organon employees must be able to satisfy all applicable travel and credentialing requirements, including associated vaccination prerequisites Shift Flexible Work Arrangements: Valid Driving License Hazardous Material(s): Number Of Openings 1 Requisition ID: R534498

Quality Auditor- AR Follow-up - Physician Revenue Cycle Management Services Location: All shifts work onsite in our Mysore , India office located at: 1st Floor, 5669, Wekreate Space Doddamane, General Thimmaiah Road, Mysuru, Karnataka, 570017 **Walk In Mon - Fri 10 am - 4 pm IST, plus Sat 9/13 & Sun 9/14 10 am - 4 pm** SHIFT: Monday - Friday from 5:30 pm - 2:30 am, IST - Onsite (No WFH) Status: Full-time, Onsite Mysore Find out more about our culture at : https://strivanthealth.com/careers/ Strivant Health is a fast-growing Medical Billing/Revenue Cycle Management company. We partner with physician practices to improve revenue cycle operations by optimizing people, processes, and technology. We provide Coding, Medical Billing, AR Follow-up Collections, Call Centers, Cash Applications, Patient Access, Authorizations, Credentialing, and Analytics designed to maximize our provider clients’ revenue. This allows our client providers to stay focused on the practice of medicine rather than the business of medicine. We have worked with over 10,000 providers representing 32+ specialties and over 30+ technology platforms in our 20+ years of business. Quality Analyst AR Follow-up - Position Summary At Strivant Health, we take pride in delivering exceptional accuracy and efficiency in physician revenue cycle management. As an Quality Auditor - Accounts Receivable Follow-up, you will play a vital role in ensuring financial success for our clients by driving efficient claims resolution, mentoring team members, and proactively identifying solutions to billing challenges. This position is more than just follow-ups and collections—it’s about providing quality checks and guidance to a team, optimizing processes, and making a real difference in the financial health of our clients. This role provides coaching to AR staff, collaborates across departments to resolve discrepancies, and supports training, reporting, and process improvements. The analyst also manages desk inventory, assists with special projects. Your work will ensure smoother operations, fewer denials, and a stronger bottom line for our healthcare partners. If you have a keen eye for detail, love solving problems, and enjoy mentoring in a fast-paced, high-volume environment, this is the perfect opportunity for you! What You’ll Do – Your Impact Matters Audit physician AR claims submissions for accuracy, completeness, and payer compliance. Track AR quality metrics and identify recurring issues Create and maintain audit tools and QA documentation. Provide feedback, training, and coaching to improve staff accuracy. Collaborate with billing, coding, and management teams to resolve discrepancies. Work hands-on with insurance follow-ups, including phone calls and payer portal interactions. Pull reports from medical billing systems and analyze trends to identify and resolve high-volume or high-dollar claims issues. Assist with reporting and analytics to track team productivity and identify areas for improvement. Collaborate with leadership to enhance processes and improve collections. Step in as needed to support backlog management and high-priority accounts. What You Bring to the Table A bachelor’s degree, ideally in healthcare-related or financial-related education programs. 3+ years of experience in physician collections, denials management, and appeals. Previous quality analyst, training or mentoring a team of accounts receivable revenue cycle professionals required. Proficient English reading, writing, and verbal skills. Excellent communication skills—able to coach with empathy and directness Familiarity with CPT, ICD-9/10, and HCPCS codes and insurance regulations. Experience working with medical billing systems and reporting tools. Proficiency in Microsoft Office (Excel, Word, Outlook, Teams). Strong analytical skills with the ability to recognize trends, generate and analyze reports from medical billing systems, and provide data-driven solutions. Experience working with 20 or more team members is a plus! Why Join Us? Make a Real Impact – Your work directly influences cash flow and financial health for healthcare providers. A Culture of Excellence – We value accuracy, innovation, and teamwork. A Supportive Team – Work with like-minded professionals who understand the complexities of revenue cycle management. Opportunities to drive change and improve processes for greater efficiency. Find out more about our culture at : https://strivanthealth.com/careers/ We are looking forward to reviewing your resume!

AR Specialist - Physician Revenue Cycle Management Services Location: All shifts work onsite in our Mysore, India office located at: 1st Floor, 5669, Wekreate Space Doddamane, General Thimmaiah Road, Mysuru, Karnataka, 570017 ** Walk In Mon - Fri 10a-4p, plus Sat 9/13 & Sun 9/14** Position Shift Hours: Monday - Friday: 5:30 pm - 2:30 am, IST Status: Full-time Find out more about our culture at : https://strivanthealth.com/careers/ Strivant Health is a fast-growing Medical Billing/Revenue Cycle Management company. We partner with physician practices to improve revenue cycle operations by optimizing people, processes, and technology. We provide Coding, Medical Billing, AR Follow-up Collections, Call Centers, Cash Applications, Patient Access, Authorizations, Credentialing, and Analytics designed to maximize our provider clients’ revenue. This allows our client providers to stay focused on the practice of medicine rather than the business of medicine. We have worked with over 10,000 providers representing 32+ specialties and over 30+ technology platforms in our 20+ years of business. AR Specialist - Position Summary At Strivant Health, we take pride in delivering exceptional accuracy and efficiency in physician revenue cycle management. As an Accounts Receivable Specialist, you will play a vital role in ensuring financial success for our clients by driving efficient claims resolution and proactively identifying solutions to physician billing challenges. This position is more than just follow-ups and collections—it’s about making a real difference in the financial health of our physician clients. You'll ensure corrected claims and help identify trends to reduce denials, which creates a stronger bottom line for our healthcare partners. If you have a keen eye for detail, love solving problems, and enjoy working in a fast-paced, high-volume environment, this is the perfect opportunity for you! What You’ll Do – Your Impact Matters Manage complex inventory, including large-dollar physician claim denial accounts and aged claims. Use your excellent problem-solving initiatives, identifying trends and offering solutions. Ensuring effective documentation communication and issue resolution. Work hands-on doing insurance follow-ups, including phone calls and payer portal interactions. Collaborate with leadership and team members to enhance processes and improve collections. What You Bring to the Table A bachelor’s degree in healthcare related or financial related education programs 3+ years of experience in AR follow-up, physician claims collections, denials management, and appeals. Previous AR follow-up claims collections experience in emergency medicine, laboratory, diagnostic, podiatry, or wound care specialties preferred. We are also open to other specialties. Excellent English communication skills, both written and verbal. Familiarity with CPT, ICD-9/10, and HCPCS codes and insurance regulations. Experience working with medical billing systems such as e-Clinical Works (eCW), Centricity (CPS), Epic. Proficiency in Microsoft Office (Excel, Word, Outlook, Teams). Strong analytical skills with the ability to recognize trends and provide data-driven solutions. Experience working with offshore teams is a plus! Why Join Us? Make a Real Impact – Your work directly influences cash flow and financial health for healthcare providers. A Culture of Excellence – We value accuracy, innovation, and teamwork. A Supportive Team – Work with like-minded professionals who understand the complexities of revenue cycle management. Opportunities to drive change and improve processes for greater efficiency. Find out more about our culture at : https://strivanthealth.com/careers/ We are looking forward to reviewing your resume!

Responsibilities: * Manage credentialing process from start to finish * Maintain accurate records and reports * Coordinate with healthcare providers and insurance companies * Ensure timely processing of applications

Roles and Responsibilities * Manage credentialing process for healthcare providers, ensuring timely and accurate processing of applications. * Coordinate with insurance companies to resolve any issues or discrepancies in provider enrollment.

Join us in pioneering breakthroughs in healthcare. For everyone. Everywhere. Sustainably. Our inspiring and caring environment forms a global community that celebrates diversity and individuality. We encourage you to step beyond your comfort zone, offering resources and flexibility to foster your professional and personal growth, all while valuing your unique contributions. Clinical Education Specialist D & A (18 Month Contract) We are looking for a Clinically focused Informatics Education Specialist with deep experience in Cardiology, Radiology, or Pathology to help bridge the gap between frontline care and advanced imaging technologies. The ideal candidate brings hands-on clinical experience in one or more of these domains and a passion for education, training, and technology adoption. In this role, you will be instrumental in optimizing imaging workflows and training clinicians on the use of Enterprise Imaging applications (PACS, CVIS, Digital Pathology platforms). Your clinical background will be essential in tailoring informatics solutions that truly support end-user needs, improve efficiency, and enhance patient care. This is a unique opportunity to combine your clinical expertise and educational skills with cutting-edge imaging technology. This is a remote role requiring frequent travel. Additionally Supporting customers in using (software) applications and solutions to the optimum extend. Providing comprehensive training for using applications and solution focused on specific customer demand. Configuring software applications to meet customer needs. Acting as an interface between customer and provider of application to solve customer problems and enhance the application with new features. Key Responsibilities Act as a clinical subject matter expert for imaging applications across Cardiology, Radiology, and/or Pathology. Lead training and educational initiatives for clinical staff on imaging systems, workflow enhancements, and system updates. Develop educational materials, job aids, and conduct one-on-one and group training sessions for clinicians, techs, and support staff. Collaborate with clinical departments to gather workflow requirements and translate them into optimized informatics solutions. Participate in go-live support, change management, and continuous education efforts post-deployment. Partner with IT and vendors to ensure that application configurations meet both clinical and operational goals. Support and educate end-users during system upgrades, new feature rollouts, and workflow transitions. Stay current on emerging trends in clinical informatics, enterprise imaging, digital pathology, and medical education. Qualifications Required Education & Clinical Background Degree in a clinical discipline (e.g., RT(R), RDCS, RN, MD, MT, or equivalent in Cardiology, Radiology, or Pathology). Minimum 3 years of hands-on clinical experience in one or more imaging specialties (e.g., Cath Lab, Diagnostic Imaging, Anatomic Pathology). Demonstrated experience teaching or mentoring peers, leading clinical training, or implementing new clinical workflows or systems. Informatics & Technical Skills Technical experience working with PACS, CVIS, RIS, LIS, and/or Digital Pathology systems. Working knowledge of imaging standards such as DICOM, HL7, and IHE workflows. Experience collaborating with IT teams on clinical system implementations or optimizations. Preferred Qualifications/Skills Bachelor's or advanced degree in Health Informatics, Clinical Education, or Healthcare Administration. Current or past registration with relevant licensing body Certifications such as CIIP, ARRT, ACLS, or clinical informatics credentials. Experience with enterprise imaging platforms (e.g., Sectra, GE, Philips, Agfa, Fuji, Visage). Experience integrating imaging solutions with EHRs (e.g., Epic Radiant/Beaker/Cupid, Cerner). Ability to work in a fast pace environment, with continuously changing and advancing technology Valid driver’s license Ability to travel domestically and internationally without restrictions Bilingualism French/English preferred, but not required Who we are: We are a team of more than 72,000 highly dedicated Healthineers in more than 70 countries. As a leader in medical technology, we constantly push the boundaries to create better outcomes and experiences for patients, no matter where they live or what health issues they are facing. Our portfolio is crucial for clinical decision-making and treatment pathways. How we work: When you join Siemens Healthineers, you become one in a global team of scientists, clinicians, developers, researchers, professionals, and skilled specialists, who believe in each individual’s potential to contribute with diverse ideas. We are from different backgrounds, cultures, religions, political and/or sexual orientations, and work together, to fight the world’s most threatening diseases and enable access to care, united by one purpose: to pioneer breakthroughs in healthcare. For everyone. Everywhere. Sustainably. To find out more about Siemens Healthineers' businesses, please visit our company page at Siemens Healthineers Canada. The Annual Base Pay For This Position Is Min $81,200 - Max $131,200 Base pay offered may vary depending on job-related knowledge, skills, and experience. Siemens Healthineers offers a variety of health and wellness benefits including paid time off and holiday pay. This information is provided per the required laws and regulations. Base pay information is based on market location. Applicants should apply via Siemens Healthineers external or internal careers site. Position must have full access to Siemens Healthineers' client sites to perform the essential functions of this position. Many clients require Siemens Healthineers employees and representatives to meet certain Vendor Credentialing requirements before they will be allowed to have access to their sites. Unless prohibited by law, position must meet all Vendor Credentialing requirements necessary to have full client access and must continue to meet those requirements during the course of employment in this position. These requirements vary by client and may include, but are not limited to: Proof of valid identification (photo, driver's license, SIN) Criminal background checks, Immunizations and Annual TB testing Healthcare training. Equal Employment Opportunity Statement: Siemens Healthineers is committed to creating a diverse environment and is proud to be an equal opportunity employer. While we appreciate all applications we receive, we advise that only candidates under consideration will be contacted. Accessibility: Siemens Healthineers is committed to excellence in serving all employees and customers, including people with disabilities. Siemens Healthineers will strive to ensure that policies and procedures established with respect to the provisions of its goods and services to persons with disabilities are consistent with the principles of dignity, independence, integration and equal opportunity as provided in the Accessibilities for Ontarians with Disabilities Act, 2005. Siemens Healthineers will continue to attempt to meet the needs of all its customers, including but not limited to persons with disabilities, in an effective and timely manner. If you require a reasonable accommodation in completing a job application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please fill out the accommodations form here. If you’re unable to complete the form, you can reach out to our HR People Connect People Contact Center for support at peopleconnectvendorsnam.func@siemens-healthineers.com. Please note HR People Connect People Contact Center will not have visibility of your application or interview status. Data Privacy: We care about your data privacy and take compliance with GDPR as well as other data protection legislation seriously. For this reason, we ask you not to send us your CV or resume by email. We ask instead that you create a profile in our talent community where you can upload your CV. Setting up a profile lets us know you are interested in career opportunities with us and makes it easy for us to send you an alert when relevant positions become open. Register here to get started. By submitting personal information to Siemens Healthineers or its affiliates, service providers and agents, you consent to our collection, use and disclosure of such information for the purposes described in our Privacy Notice here. To all recruitment agencies: Siemens Healthineers does not accept agency resumes. Please do not forward resumes to our jobs alias, employees, or any other company location. Siemens Healthineers is not responsible for any fees related to unsolicited resumes. Beware of Job Scams: Please beware of potentially fraudulent job postings or suspicious recruiting activity by persons that are currently posing as Siemens Healthineers recruiters/employees. These scammers may attempt to collect your confidential personal or financial information. If you are concerned that an offer of employment with Siemens Healthineers might be a scam or that the recruiter is not legitimate, please verify by searching for the posting on the Siemens Healthineers career site.

Vanderbilt University: School of Nursing Location Nashville Open Date Jun 10, 2025 Description The Vanderbilt School of Nursing seeks qualified applicants for a full-time faculty position to serve as the Accredited Provider Program Director (APPD) for Vanderbilt School of Nursing Accreditation Process. Working closely with VUSN Faculty and others, the Nurse Educator for Professional Development will design, plan, implement, and evaluate Nursing Continuing Professional Development (NCPD) activities in compliance with American Nurses Credentialing Center (ANCC) guidelines. Additionally, the Nurse Educator for Professional Development will Educate Faculty on ANCC NCPD Criteria and Standards for Integrity and Independence in Accredited Continuing Education. Key Functions And Expected Performance Represent Vanderbilt School of Nursing as the AAPD and in all ANCC-NCPD related activities. Serve as Nurse Planner and collaborate with faculty and stakeholders to assess professional practice gaps, design, implement, and evaluate NCPD activities in compliance with ANCC guidelines. Lead the ANCC-NCPD reaccreditation process. Establish and guide advisory and planning committees. Ensure compliance with financial disclosure requirements, maintain content integrity, and promote active learner engagement. Use summative evaluation data to inform and improve future programming. Maintain comprehensive records of planning processes, disclosures, evaluations, and outcomes as required by ANCC. Collaborate with internal and external stakeholders to interpret ANCC standards, apply evolving accreditation expectations, and guide continuous quality improvement initiatives across the NCPD program. This is a 12-month, renewable, non-tenure-track appointment. Salary and rank are commensurate with experience. Full-time faculty must maintain residency in the state or be willing to relocate to Tennessee for regular, on-campus engagement in VUSN activities. Qualifications A master’s degree in nursing is required and will be ranked at the instructor level; a doctoral degree in nursing is required for rank at the assistant professor level or higher An active, unencumbered license as a registered nurse or advanced practice nurse in Tennessee or eligibility to obtain licensure in Tennessee Prior experience working with diverse populations 3+ years of previous experience in a similar role Experience with ANCC-accredited NCPD programs Experience in Educational Design and Evaluation Ability to work with others at all levels across an organization and beyond Application Instructions Applicants for the faculty position should initially submit a cover letter and either a resume or a curriculum vitae. The cover letter should summarize your qualifications for the position. For questions related to the posting, please email vusnfacultyrecruitment@vanderbilt.edu.

Medical Content Writer (Credentialing & RCM) (Night Shift - Remote) - Work from Home Our client is looking for a medical content writer for their US Medical Credentialing & RCM business Domain working 100% Remote in US hours, 9am EST - 6pm EST. This is a full time role working 40 hours/week starting ASAP. We’re looking for someone who can: - Write website copies, blog posts, articles, press releases, product descriptions, and similar creative content, -Create engaging, high-level content aimed at healthcare decision-makers, driving lead generation and brand positioning across services like RCM, billing, credentialing. -with direction from the SEO Manager, you would develop comprehensive, SEO-optimized medical billing & coding guides across multiple specialties translating complex compliance and regulatory data into accessible, high-impact resources. - Collaborate with the SEO team to provide SEO content or optimize existing content with the provided SEO keywords, - Revise or edit content as per the instructions, guidelines, and standards set by the editor, - Communicate with business unit members to discuss project details and requirements, - Produce high-quality, AI-free, and plagiarism-free content. We’re looking for someone who has: - At least 2 - 3 years of experience in Medical Credentialing & RCM content writing - At least 2 - 3 years of experience writing in US English. - A MASTERY of US English grammar. - Fluent in written and spoken English. - 100% Remote work from home - Can comfortably write minimum of 3000 words/day. Interview Process: Expect to write a 1000 word blog which must be plagiarism-free and AI-free and 100% original, then video interview. Interested candidates please send their resume. Job Type: Full-time / Monthly Salary Work Location: Remote

Job Summary Join our dynamic team as a Specialist in Provider Credentialing where you will leverage your expertise in healthcare products and credentialing processes to ensure compliance and efficiency. With 4 to 6 years of experience you will play a crucial role in maintaining the integrity of our provider network. This hybrid role offers the flexibility of night shifts allowing you to balance work and personal commitments effectively. Responsibilities Oversee the credentialing and re-credentialing processes for healthcare providers to ensure compliance with industry standards and regulations. Collaborate with cross-functional teams to streamline credentialing workflows and improve operational efficiency. Analyze provider data to identify discrepancies and implement corrective actions to maintain data accuracy. Develop and maintain comprehensive documentation of credentialing procedures and policies. Provide support and guidance to providers throughout the credentialing process to ensure a smooth and efficient experience. Monitor and report on credentialing metrics to identify trends and areas for improvement. Implement best practices in credentialing to enhance the quality and reliability of provider information. Coordinate with external agencies and stakeholders to facilitate timely credentialing approvals. Utilize healthcare product knowledge to optimize credentialing processes and ensure alignment with organizational goals. Conduct regular audits of credentialing files to ensure compliance with internal and external standards. Assist in the development and delivery of training programs for new team members on credentialing procedures. Participate in continuous improvement initiatives to enhance the overall effectiveness of the credentialing department. Ensure all credentialing activities are conducted in accordance with company policies and regulatory requirements. Qualifications Possess a strong understanding of healthcare products and their application in credentialing processes. Demonstrate expertise in credentialing and re-credentialing within the healthcare domain. Exhibit excellent analytical skills to assess provider data and identify discrepancies. Show proficiency in developing and maintaining documentation of credentialing procedures. Display strong communication skills to support providers and collaborate with cross-functional teams. Have experience in monitoring and reporting on credentialing metrics. Be adept at coordinating with external agencies for credentialing approvals. Certifications Required Certified Provider Credentialing Specialist (CPCS)

We are pleased to inform you that we are conducting a Walk-in Drive from 12:00 PM to 3:00 PM at our Bangalore location • Exp: Min 1 to 4 years in AR domain/ Denial Management Role: Associate / Senior AR Associates/ Analyst/Credentialing Specialist Required Candidate profile Process: Physician Billing or Hospital Billing - Denial Management Voice Priority: High – quality profiles are requested Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

1. Hospital Empanelment: Identify and approach hospitals and diagnostic centers for empanelment based on business expansion needs. Negotiate rates and services as per TPA guidelines and finalize agreements. Handle documentation and ensure hospitals meet regulatory and credentialing standards. Coordinate signing of contracts and onboarding procedures. 2. Provider Network Development: Continuously expand and strengthen the provider network in line with business needs and geographic expansion. Maintain a balance of multispecialty, tertiary care, and specialty hospitals across regions. Conduct provider gap analysis to ensure network adequacy. 3. Relationship Management: Serve as the point of contact for empaneled hospitals. Resolve provider issues related to payments, claims processing, and authorization. Conduct regular visits to hospitals to maintain rapport and ensure satisfaction. 4. Compliance & Documentation: Ensure adherence to IRDAI guidelines and company policies for provider empanelment. Maintain and update provider database, contracts, and tariffs. Ensure proper documentation and digital recordkeeping for audits and compliance. 5. Internal Coordination: Work closely with claims, pre-auth, customer service, and IT teams for provider-related issues. Share regular updates of new empanelments, tariff revisions, and hospital network changes. Job Types: Full-time, Permanent Pay: ₹25,000.00 - ₹35,000.00 per month Benefits: Health insurance Provident Fund

Job Title: Healthcare Recruiter - Night Shift Location: Vadodara Employment Type: Full-Time | Entry-Level (0–2 Years Experience) Shift: Night Shift only Job Summary We are looking for a motivated and people-focused Healthcare Recruiter to join our growing team. This entry-level role (0–2 years of experience) is ideal for individuals eager to build a career in recruitment and talent acquisition within the healthcare industry. You will support the hiring process by sourcing, screening, and coordinating candidates for nursing, allied health, and other clinical/non-clinical positions. Key Responsibilities Source and identify healthcare professionals through job boards, social media, referrals, and networking. Review resumes and pre-screen candidates to ensure qualifications align with requirements. Coordinate interviews between candidates and hiring managers. Assist candidates through the onboarding process, including credentialing and compliance. Maintain accurate candidate and client information in the applicant tracking system (ATS). Build and maintain strong relationships with candidates to ensure a positive experience. Provide support to senior recruiters and account managers in daily recruitment activities. Stay informed on healthcare staffing trends and workforce needs. Qualifications Required: Bachelor’s degree (or equivalent experience). 0–2 years of experience in recruitment, human resources, healthcare, sales, or customer service. Strong communication, interpersonal, and organizational skills. Ability to multitask and thrive in a fast-paced environment. Proficiency with Microsoft Office (Word, Excel, Outlook) and comfort using online platforms. Preferred: Exposure to healthcare recruitment, HR, or staffing. Familiarity with applicant tracking systems (ATS) and recruitment tools. What We Offer Structured training and mentorship for new recruiters. Competitive base salary with performance-based incentives. Career growth opportunities in healthcare staffing and human resources. Supportive, team-oriented work environment with a focus on learning and development.

About the job About Client: Our Client is a global IT services company headquartered in Southborough, Massachusetts, USA. Founded in 1996, with a revenue of $1.8B, with 35,000+ associates worldwide, specializes in digital engineering, and IT services company helping clients modernize their technology infrastructure, adopt cloud and AI solutions, and accelerate innovation. It partners with major firms in banking, healthcare, telecom, and media. Our Client is known for combining deep industry expertise with agile development practices, enabling scalable and cost-effective digital transformation. The company operates in over 50 locations across more than 25 countries, has delivery centers in Asia, Europe, and North America and is backed by Baring Private Equity Asia. Job Title : Business Analyst US Healthcare Domain Key Skills : Business, HL7, FHIR, X12, BRDs, FRDs, Use Cases, Traceability Matrices. Experience : 6-8 Years Location: PAN INDIA Education Qualification : Any Graduation Work Mode : Hybrid Employment Type : Contract to Hire Notice Period : Immediate - 10 Days. Job Description : Key Responsibilities: Strategic Analysis & Solutioning: Lead end-to-end business analysis for large-scale healthcare IT projects. Partner with business leaders to identify opportunities for digital transformation and operational efficiency. Define and document high-level business requirements, functional specifications, and solution architecture inputs. Conduct feasibility studies, gap analysis, and impact assessments for new initiatives. Domain Expertise – US Healthcare: Deep understanding of Claims lifecycle: submission, adjudication, payment, and denial management. Expertise in Provider workflows: credentialing, contracting, network management, and data governance. Strong knowledge of Care Management: utilization review, case management, disease management, and appeals. Familiarity with Medicare/Medicaid regulations, HIPAA compliance, and value-based care models. Technical Collaboration: Collaborate with product owners, architects, and developers to translate business needs into scalable solutions. Drive API integration strategies, data mapping, and ETL workflows for healthcare data. Ensure adherence to healthcare interoperability standards like HL7, FHIR, X12, and 508 Accessibility. Contribute to UI/UX design discussions and ensure alignment with workflow requirements. Required Skills & Experience: Core Business Analysis: Advanced proficiency in requirements elicitation, stakeholder management, and business case development. Strong documentation skills: BRDs, FRDs, Use Cases, Traceability Matrices. Experience in workflow modeling, process reengineering, and change management. Healthcare Technology: Hands-on experience with healthcare SaaS platforms, multi-tenant systems, and clinical data models. Strong understanding of claims adjudication engines, provider data platforms, and care coordination tools. Experience with data extracts, reporting tools, and analytics dashboards.

Location: Louisville, US. Hybrid Working / Eastern Time-zone cloud native platform architect need candidates with B1 visa USA Role Definition Serves as the technical anchor for the modernization journey. Defines and evolves the platform architecture with a strong focus on healthcare provider data pipelines, provider data lifecycle management, credentialing, attestation, and compliance-driven workflows. Leads workshops and discovery sessions to align platform modernization with organizational priorities, covering infrastructure blueprinting, automation, cost optimization, and workflow/data architecture reviews. Experience Level · 12–15+ years in enterprise and platform architecture, with healthcare data experience preferred. · Proven track record with AWS as the primary cloud platform (design, migration, modernization, and cost optimization). · Exposure to Azure and GCP for hybrid/multi-cloud use cases. Skills Needed · AWS platform expertise (must-have): EC2, S3, RDS (Postgres), Lambda, API Gateway, CloudFormation/Terraform, monitoring & observability. · Provider data lifecycle management (golden record, credentialing, verification, attestation). · Expertise in data pipelines, API-driven integration, workflow orchestration (Elsa, Mass Transit). · Infrastructure automation (IaC), resilience engineering, FinOps. · Ability to facilitate workshops and translate architecture into actionable roadmaps.

About the job About Client: Our Client is a global IT services company headquartered in Southborough, Massachusetts, USA. Founded in 1996, with a revenue of $1.8B, with 35,000+ associates worldwide, specializes in digital engineering, and IT services company helping clients modernize their technology infrastructure, adopt cloud and AI solutions, and accelerate innovation. It partners with major firms in banking, healthcare, telecom, and media. Our Client is known for combining deep industry expertise with agile development practices, enabling scalable and cost-effective digital transformation. The company operates in over 50 locations across more than 25 countries, has delivery centers in Asia, Europe, and North America and is backed by Baring Private Equity Asia. Job Title : Business Analyst US Healthcare Domain Key Skills : Business, HL7, FHIR, X12, BRDs, FRDs, Use Cases, Traceability Matrices. Experience : 6-8 Years Location: PAN INDIA Education Qualification : Any Graduation Work Mode : Hybrid Employment Type : Contract to Hire Notice Period : Immediate - 10 Days. Job Description : Key Responsibilities: Strategic Analysis & Solutioning: Lead end-to-end business analysis for large-scale healthcare IT projects. Partner with business leaders to identify opportunities for digital transformation and operational efficiency. Define and document high-level business requirements, functional specifications, and solution architecture inputs. Conduct feasibility studies, gap analysis, and impact assessments for new initiatives. Domain Expertise – US Healthcare: Deep understanding of Claims lifecycle: submission, adjudication, payment, and denial management. Expertise in Provider workflows: credentialing, contracting, network management, and data governance. Strong knowledge of Care Management: utilization review, case management, disease management, and appeals. Familiarity with Medicare/Medicaid regulations, HIPAA compliance, and value-based care models. Technical Collaboration: Collaborate with product owners, architects, and developers to translate business needs into scalable solutions. Drive API integration strategies, data mapping, and ETL workflows for healthcare data. Ensure adherence to healthcare interoperability standards like HL7, FHIR, X12, and 508 Accessibility. Contribute to UI/UX design discussions and ensure alignment with workflow requirements. Required Skills & Experience: Core Business Analysis: Advanced proficiency in requirements elicitation, stakeholder management, and business case development. Strong documentation skills: BRDs, FRDs, Use Cases, Traceability Matrices. Experience in workflow modeling, process reengineering, and change management. Healthcare Technology: Hands-on experience with healthcare SaaS platforms, multi-tenant systems, and clinical data models. Strong understanding of claims adjudication engines, provider data platforms, and care coordination tools. Experience with data extracts, reporting tools, and analytics dashboards.

Role Overview: You will be responsible for conducting market research to identify potential Pediatrics and OBGY doctors, maintaining a database of doctors, and engaging with them for collaboration opportunities. Additionally, you will coordinate with HR for the seamless onboarding of doctors, oversee credentialing and privileging processes, monitor performance, organize meetings/events, manage relationships between administration and doctors, and ensure compliance with healthcare regulations. Key Responsibilities: - Conduct market research to identify and assess potential Pediatrics and OBGY doctors - Maintain a database of prospective and current doctors - Engage with identified doctors for potential collaboration opportunities - Coordinate with HR for seamless onboarding - Ensure necessary documentation, contracts, and agreements are in place - Familiarize new doctors with hospital policies, procedures, and systems - Oversee credentialing processes ensuring compliance with standards - Manage privileging processes based on qualifications and experience - Update records related to doctors" credentials and privileges - Monitor performance using KPIs and feedback mechanisms - Provide reports on doctor performance with recommendations - Organize regular consultants meetings for effective communication - Act as the primary contact between hospital administration and doctors addressing concerns or issues - Foster strong professional relationships ensuring satisfaction - Ensure all processes comply with relevant healthcare regulations - Stay updated on changes in healthcare laws that may impact doctor relations Qualifications Required: - Bachelor's degree in a relevant field (e.g., healthcare management, business administration) - Previous experience in healthcare administration or similar role preferred - Strong communication and interpersonal skills - Ability to multitask and prioritize effectively - Knowledge of healthcare regulations and compliance requirements (Note: The job description does not include any additional details about the company.),

Job Title: Sr. Healthcare Recruiter Location: Zirakpur, Chandigarh Area Experience Required: 5+ Years in Healthcare Recruitment for the US. Employment Type: Full-Time. Job Summary: We are seeking an experienced and motivated Sr. Healthcare Recruiter with a strong background in travel nursing and allied health staffing . The ideal candidate will have 5 + years of hands-on healthcare recruitment experience , in-depth knowledge of healthcare credentialing , and a clear understanding of healthcare compliance regulations . Key Responsibilities: Source, screen, and recruit qualified travel nurses and allied health professionals across the U.S. Build and maintain a pipeline of active and passive healthcare candidates through job boards, databases, referrals, and social media. Coordinate and manage the end-to-end recruitment process , from job posting to offer acceptance. Ensure candidates meet credentialing and compliance requirements, including licenses, certifications, background checks, and immunisation records. Deep understanding and implementation of The Joint Commission's Standards and processes. Maintain knowledge of federal and state healthcare regulations , including JCAHO, HIPAA, and OSHA standards. Collaborate with account managers and clients to understand staffing needs and deliver qualified candidates within deadlines. Keep accurate records of candidate activity and compliance documentation in ATS/CRM systems. Provide a high-quality candidate experience and ensure consistent communication throughout the recruitment process. Qualifications: Bachelor’s degree or equivalent work experience in healthcare staffing or HR. Minimum 5 years of healthcare recruitment experience , specifically in travel nursing and allied health . Strong understanding of healthcare credentialing, onboarding, and compliance requirements. Proficiency in applicant tracking systems (ATS), sourcing tools, and CRM software. Excellent communication, organisational, and negotiation skills. Ability to work in a fast-paced, target-driven environment. Experience working with MSPs, hospitals, or healthcare systems . Familiarity with travel healthcare staffing models . Why Join Staffingine? Growth opportunities in one of the fastest-growing healthcare solutions organisations. Supportive team culture with ongoing training and development Work with industry-leading clients across the U.S. Competitive and attractive salary, and lucrative performance-based incentives. Opportunities to enrol for several Learning & development programs. Earn diversified Industries' knowledge and certifications with unlimited Rewards and Recognition. Supportive, transparent, and growth-oriented work environment. Opportunity to work with a dynamic, experienced, and collaborative team. Apply now and help top healthcare professionals serve the people who need them most for better health and life. Gratitude HR Department Staffingine LLC

A Credentialing Manager is primarily responsible for overseeing and managing the process by which healthcare providers are verified and approved to deliver care within healthcare organizations, insurance networks, or medical facilities. Their role ensures compliance with regulatory standards, accreditation requirements, and internal policies. Here’s a detailed breakdown of typical roles and responsibilities: 1. Credentialing and Provider Verification Verify the qualifications, licenses, certifications, and credentials of healthcare providers (doctors, nurses, allied health professionals). Ensure compliance with state, federal, and payer-specific regulations. Maintain accurate and up-to-date credentialing records. Perform primary source verification of education, training, licensure, and work history. 2. Compliance and Regulatory Oversight Ensure compliance with accrediting bodies such as NCQA (National Committee for Quality Assurance), URAC, The Joint Commission, or state regulatory agencies. Maintain knowledge of current laws, regulations, and industry standards related to provider credentialing. Prepare for and facilitate audits or inspections by external regulatory agencies. 3. Credentialing Process Management Manage the end-to-end credentialing process, from provider application to approval. Track expiration dates for licenses, certifications, and insurance coverage. Oversee re-credentialing processes (usually every 2–3 years, depending on organization policies). Handle credentialing for new hires, network providers, or contracted professionals. 4. Communication and Coordination Serve as the primary point of contact for providers, staff, and external entities regarding credentialing. Coordinate with HR, compliance, legal, and payer departments. Respond to provider inquiries and resolve credentialing issues or delays. 5. Data Management and Reporting Maintain credentialing databases and electronic filing systems. Generate reports on credentialing status, compliance, and upcoming renewals. Monitor key performance indicators (KPIs) related to credentialing efficiency and accuracy. 6. Staff Supervision and Training (if applicable) Supervise credentialing specialists or assistants. Develop training programs for new staff on credentialing procedures and standards. Ensure team members follow consistent processes and meet deadlines. 7. Quality Improvement Continuously review and improve credentialing processes. Implement best practices to reduce errors and ensure timely provider approvals. Stay informed of emerging trends, technologies, and tools in credentialing. Skills & Qualifications Usually Required: Knowledge of healthcare regulations, licensing, and accreditation standards. Attention to detail and strong organizational skills. Proficiency in credentialing software (e.g., CAQH ProView, symplr, Credentialing Hub). Strong communication, negotiation, and problem-solving abilities. Experience in healthcare administration or medical staff services. Job Type: Full-time Pay: From ₹50,000.00 per month Benefits: Food provided Health insurance Provident Fund Ability to commute/relocate: Chennai District, Tamil Nadu: Reliably commute or planning to relocate before starting work (Preferred) Education: Bachelor's (Preferred)

Designation: AR Caller / Senior AR Caller Experience: Minimum 1 years Strong understanding of UB04 claim forms and related processes Required Candidate profile Notice Period: Immediate joiners or candidates with a maximum 15-day notice period are highly preferred. Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

Senior Business Analyst + Project Manager - Healthcare AI Solutions Position Overview We're seeking a versatile Senior Business Analyst with strong project management capabilities to join our team building AI-driven healthcare solutions. This hybrid role is perfect for someone who excels at both detailed requirement analysis and project execution. As we scale, this position will evolve to focus primarily on business analysis while mentoring additional team members. Key Responsibilities Business Analysis Requirements Engineering Elicit, analyze, and document detailed functional and non-functional requirements Create comprehensive BRDs, FRDs, and technical specifications Develop user stories with clear acceptance criteria in Azure DevOps Map complex healthcare workflows (RCM cycles, credentialing processes, patient journeys) Design process flow diagrams, data flow diagrams, and system architecture diagrams Healthcare Domain Analysis Document healthcare-specific requirements (HIPAA, HL7, FHIR standards) Analyze integration requirements with EHR/PMS systems Create data mapping documents for healthcare data exchange Identify compliance checkpoints in product workflows Research and document competitor features and industry best practices AI/ML Requirements Define conversational flows for AI agents Document prompt engineering requirements and expected AI behaviors Create test scenarios for AI responses and edge cases Define success metrics for AI agent performance Work with ML engineers to document training data requirements Project Management Agile Delivery Facilitate scrum ceremonies (standups, sprint planning, retrospectives) Maintain product backlog and sprint boards in Azure DevOps Track sprint velocity, burndown charts, and team capacity Coordinate releases and deployment schedules Manage dependencies between India and US teams Stakeholder Coordination Create and maintain project roadmaps and release plans Prepare weekly status reports for leadership Coordinate UAT sessions with US healthcare clients Schedule and facilitate requirement gathering sessions across time zones Manage stakeholder expectations and communication Team Leadership Mentor junior analysts as team grows Establish BA best practices and templates Create knowledge repository for healthcare domain Train team on US healthcare workflows and terminology Build reusable requirement templates for common features Required Qualifications Must-Have: 6-8 years of experience with at least 3 years as Senior BA 2+ years of project management/scrum master experience Experience in healthcare IT or healthtech products Strong technical aptitude (ability to read API documentation, understand databases) Expertise in Azure DevOps or similar ALM tools Advanced skills in Visio, Lucidchart, or similar diagramming tools Excellent written and verbal English communication Experience working with US clients/stakeholders Proven ability to manage multiple projects simultaneously Preferred: Healthcare domain certifications (CAHIMS, CPHIMS) Agile certifications (CSM, CSPO, PMI-ACP) Experience with AI/ML projects or conversational AI Knowledge of US healthcare regulations (HIPAA, HITECH) Experience with EHR/PMS integrations SQL skills for data analysis API documentation experience Technical Skills: Azure DevOps (mandatory) JIRA/Confluence Microsoft Office Suite (advanced Excel) Postman or similar API testing tools Basic SQL for data validation Wireframing tools (Figma, Balsamiq) Key Competencies Analytical Excellence Break down complex healthcare workflows into manageable components Identify gaps between current and future state Strong problem-solving and critical thinking Attention to detail without losing sight of big picture Communication Bridge Translate between technical teams and business stakeholders Present complex information simply Facilitate productive meetings across cultures and time zones Create clear, concise documentation Execution Focus Self-starter who can work independently Comfortable with ambiguity in startup environment Ability to prioritize in fast-paced setting Results-oriented with strong follow-through Healthcare Acumen Quick learner of healthcare terminology and workflows Understanding of provider pain points Awareness of regulatory implications Patient-safety mindset Success Metrics First 90 Days: Complete domain knowledge transfer on US healthcare systems Document current state of NeoScribe and create improvement roadmap Establish requirement templates and project tracking systems Build relationships with key stakeholders in India and US First Year: Deliver 3 major product releases on schedule Achieve 90% stakeholder satisfaction on requirement clarity Reduce requirement-related defects by 50% Build comprehensive healthcare workflow library Successfully onboard and mentor 2 junior BAs Maintain <5% scope creep across projects What We Offer Employee stock options Health insurance for family Flexible working hours to accommodate US time zone meetings Learning budget for certifications and courses Opportunity to shape products impacting healthcare delivery Clear growth path to Head of Business Analysis or Product Management Growth Trajectory As the team scales, this role will evolve to: 6 months: Transition PM duties to dedicated Project Manager, focus on complex BA work 12 months: Lead BA with 2-3 analysts reporting 24 months: Head of Business Analysis or transition to Product Management Why This Role is Unique: You'll be building AI agents that transform healthcare operations, working directly with US healthcare providers to solve real problems. This is a rare opportunity to combine healthcare domain expertise with cutting-edge AI technology while growing from an IC role to leadership as we scale. Powered by JazzHR wMoBmVaL7N

We are pleased to inform you that we are conducting a Walk-in Drive from 12:00 PM to 3:00 PM at our Bangalore location. • Experience: Minimum 1 to 4 years in AR domain/ Denial Management Role: Associate / Senior AR Associates/ Analyst Required Candidate profile Process: Physician Billing or Hospital Billing - Denial Management Voice Priority: High – quality profiles are requested Job Location Bangalore Email: manijob7@gmail.com Call or Whatsapp 9989051577

Overview Manager, Quality and Care Management Full time, 80 Hours Per Pay Period, Day shift Fort Loudoun Medical Center is equipped with a team of more than 200 doctors in more than 29 specialty areas. Our 87,000-square-foot hospital features advanced technology, including state-of-the-art Magnetic Resonance Imaging (MRI), Computerized Tomography (CT), Ultrasound, Diagnostic X-Rays and Women’s Imaging Services, as well as Nuclear Medicine technology unique to our surrounding counties. The physicians, staff and volunteers of Fort Loudoun Medical Center are dedicated to providing excellent care to every patient, every time. Position Summary Responsible for the planning, organization, management, and evaluation of operations of quality, care management, infection prevention, performance improvement, regulatory compliance, and medical staff services of assigned facilities. Responsible for the coordination of care and outcomes of clinical and operational metrics for all patients through the continuum of care. Knowledgeable in quality improvement principles, regulatory, and Care Management standards. The manager is responsible for budget management, staffing, hiring, discipline, and performance management for applicable departments. The Quality Manager/Care Manager is responsible for collaborating with appropriate enterprise leaders when applicable. When the Quality Manager does not have oversight of Care Management, those applicable accountabilities and performance criteria are non-applicable. Recruiter: Brittany Smithson || apply@covhlth.com Responsibilities Develops department budgets that reflect effective management of resources to provide services. In collaboration with enterprise leadership, facility leadership, and medical staff, assists in the development of strategic initiatives for the department and facility. Collaborates with interdisciplinary groups and leaders to identify and monitor key processes and patient outcomes. Uses various data sources, including but not limited to, publicly reported data to inform which processes and outcomes to monitor. Facilitates effective communication of results to medical staff and other key stakeholders. Identifies opportunities for improvement using Covenant performance improvement methodologies to implement corrective action plans and evaluate results for desired outcomes. Manages Care Management functions to ensure the coordination of care for patients so they move seamlessly through the continuum of care. Stays abreast of regulatory, licensing, and certification (Joint Commission, CMS, Leapfrog, State, etc.) standards to ensure processes are in place to achieve desired outcomes. Collaborates with the Peer Review/PQPR medical staff chair to operationalize assessments of peer review triggers and functions of the facility medical staff. Collaborates with clinical and medical staff to implement processes, as needed, to ensure financial and length of stay metrics are assessed and communicated to applicable medical staff and organizational leaders. Operationalizes a Care Management Model to ensure timely and effective throughput through the continuum of care. Serves as a coach, mentor, and role model for all team members. Oversees activities of medical staff credentialing, FPPE/OPPE, and departmental organization including, but not limited to, facilitating applicable medical committee meetings to ensure effective patient safety and regulatory compliance. Collaborates with enterprise infection prevention management and local leaders to assess and support the infection prevention strategies as needed. Oversees survey action plans and ongoing assessments of regulatory readiness for all accreditation, certification, and state surveys. Collaborates with nursing, medical staff, and other disciplines to assess and improve outcomes related to performance with various measures associated with publicly reported entities. Proactively seeks opportunities to reduce waste and redundancy in the utilization of resources. At a minimum participates in the Quality, Peer Review, Regulatory, Infection Prevention, and Credentials Committees. The Quality Manager may serve as the committee facilitator as needed. Communicates with medical staff to improve utilization of resources and compliance with evidenced based care as deemed necessary. Collaborates with medical staff and facility leadership to determine the frequency, quality, and monitoring of multidisciplinary rounds. Provides data to stakeholders on an ongoing basis to inform stakeholders on progress towards applicable enterprise and business unit clinical and operational goals. Local travel required. Follows policies, procedures, and safety standards. Completes required education assignments annually. Works toward achieving goals and objectives, and participates in quality improvement initiatives as requested. Performs other duties as assigned. Qualifications Minimum Education: Bachelor’s degree or higher in Nursing, Social Work, Healthcare Administration, Public Health, or other related field. Minimum Experience A minimum of five (5) years of experience with at least three (3) years in a hospital setting. Licensure Requirement Must have and maintain a valid Tennessee RN license if degree is in Nursing. CCM, ACM, or CPHQ certification preferred. Employee must have a valid Tennessee driver’s license and state mandated minimum insurance coverage. Driving record must meet Covenant Health minimum standards at the date of hire and throughout employment tenure.

Job Title: Associate Payment Posting Years of Experience: 2-3 years Location: Hyderabad, Telangana Mode of interview: In-person. Mode of operation: Work from office Shift Timings: 9:00 a.m.–6:00 p.m Job Description Functional Expertise: Should be able to post ERAs and Manual posting, patient-cash, check and CC payments. Should have strong understanding of medical billing terms, such as co-pays, coinsurances, deductibles allowable amount, contractual adjustments, out-of network and in-network processing, retractions/recoupments, capitation payments, Collection agency payments, MVA and WC payments, Correspondence and Zero claims. Should be able to access websites to retrieve, process and upload the EOBs. Should be able to identify line item denials for non-covered services, inclusive services, credentialing, medical necessity, non-par, no-auth denials, COB Denials and associated denial reason codes. Medicare claims processing-sequestration, interest payment, reporting codes, Modifiers Should be able to understand Payer specific guidelines, process secondary and Tertiary claims and patient statements. Process Insurance and patient refunds. Should be capable of interpreting and processing the EOBs, research, correct and re-file denied claims. Reconciliation and balancing the payment batches. Operational Duties: Comply to daily productivity and Accuracy standards. Submit daily production reports to team lead. Stay in constant communication with team lead /operations manager Professional & behaviour is expected Receive feedback from QA on errors and follow updated protocol. Additional Comments Preferably having experience with NG/eCW practice manager

Job Title: Credentialing Executive Location: Hyderabad, Telangana Company: Harmony United Medsolutions Pvt. Ltd. About Us: Harmony United Medsolutions Pvt. Ltd. [HUMS] is a dynamic and innovative company dedicated to revolutionizing the Healthcare Industry. We at HUMS take pride in being a reliable partner as a Healthcare Management Company. With nine years of experience, we have perfected our end-to-end services in medical billing, A.R. management, and other essential healthcare facets. We provide our services to Harmony United Psychiatric Care, a US-based Healthcare Company. We pride ourselves on our commitment to excellence, creativity, and pushing the boundaries of what's possible. As we continue to grow, we seek a talented candidate to join our team and contribute to our exciting projects. Position Overview: The Credentialing Executive will be responsible for managing the credentialing and re-credentialing processes for psychiatric care providers within our network. The role will also focus on maintaining up-to-date provider documentation, ensuring compliance with insurance companies, and monitoring provider licensing. This position requires a detail-oriented and proactive individual to ensure the smooth integration of providers into the insurance network and their continued compliance. Responsibilities: Assist in the enrollment of providers with insurance companies, ensuring all required documentation is submitted timely and accurately. Collect, verify, and maintain the necessary documentation for all providers, ensuring compliance with regulatory standards and insurance requirements. Proactively follow up with insurance companies to track the status of credentialing applications, resolve issues, and ensure providers are credentialed in a timely manner. Coordinate and manage the re-credentialing process for existing providers, ensuring timely submissions and compliance with insurance companies’ requirements. Monitor and maintain CAQH (Council for Affordable Quality Healthcare) profiles for all providers, ensuring accuracy and compliance with industry standards. Oversee the process of enrolling providers with Medicare, ensuring compliance with all relevant regulations and ensuring successful enrollment. Requirements: Minimum of 5 years of experience in healthcare credentialing or provider relations, preferably in US healthcare sector. Candidate must have a bachelor’s degree in any field. Experience with insurance portals, CAQH, and Medicare enrollment systems Excellent communication and interpersonal skills, with the ability to build rapport and trust at all levels of the organization. In-depth knowledge of credentialing processes, insurance company contracting, and regulatory requirements in the healthcare sector. Strong organizational and time management skills, with the ability to handle multiple tasks and deadlines. Ability to maintain confidentiality and work with sensitive provider data in a HIPAA-compliant manner. Diversity, equality, and inclusion Diversity, equality, and inclusion are fundamental to our success at HUMS. We actively promote diversity across all aspects of our organization, including but not limited to gender, race, ethnicity, sexual orientation, religion, disability, and age. We strive to foster an inclusive culture where diverse perspectives are embraced and everyone has equal opportunities to grow, contribute, and succeed. Benefits: Competitive salary (including EPF and PS) Health insurance Four days’ workweek (Monday – Thursday) Opportunities for career growth and professional development Additional benefits like food and cab-drop are available Please submit your resume and cover letter detailing your relevant experience and why you fit this role perfectly. We look forward to hearing from you! In case of any queries, please feel to reach out us at recruitment@hupcfl.com Note: Available to take calls between 4:45 PM to 3:45 AM IST only from Monday to Thursday. #LI-DNI gw4Cj8PFVg

Job Title: Associate Payment Posting Years of Experience: 1–2 years Location: Hyderabad, Telangana Mode of interview: In-person. Mode of operation: Work from office Shift Timings: 9:00 a.m.–6:00 p.m Job Description Functional Expertise: Should be able to post ERAs and Manual posting, patient-cash, check payments. Should have strong understanding of medical billing terms, such as co-pays, coinsurances, deductibles allowable amount, contractual adjustments, out-of network and in-network processing, retractions/recoupments and Zero claims. Should be able to identify line item denials for non-covered services, inclusive services, credentialing, medical necessity, non-par, no-auth denials, COB Denials and associated denial reason codes. Medicare claims processing-sequestration, interest payment, reporting codes, Modifiers Should be able to understand Payer specific guidelines, process secondary and Tertiary claims and patient statements. Reconciliation and balancing the payment batches. Operational Duties: Comply to daily productivity and Accuracy standards. Submit daily production reports to team lead. Stay in constant communication with team lead /operations manager Professional & behavior is expected Receive feedback from QA on errors and follow updated protocol. Additional Comments Preferably having experience with NG/eCW practice manager