921 Credentialing Jobs - Page 30

Greetings from ACP Billing Services! We are hiring for the following roles - Work from Office Charge Posting - Near Madhavaram Location Experience & Requirements: Minimum 3+ years of experience in US Medical Billing. Strong verbal and written communication skills. Charge Posting candidates with good typing skills will have an added advantage. Competitive remuneration as per industry standards. Spot offers for selected candidates. Immediate joiners are preferred. Responsibilities: Process medical billing transactions with a 99% or higher accuracy rate. Understand and apply customer-provided business rules while ensuring compliance with turnaround time requirements. Work collaboratively in teams to achieve set targets. Utilize medical billing expertise to monitor and report customer KPIs. Actively participate in learning programs and compliance initiatives. Competencies & Skills: Strong interpersonal and analytical skills. Proficiency in MS Office (Word, Excel, PowerPoint). Adaptability, flexibility, and a proactive approach to tasks. Commitment to meeting productivity, quality, and attendance SLAs. Team-oriented mindset with a willingness to take initiative. Work Location : ACP Billing Services Pvt Ltd - NO.133, 2ND FLOOR, EJNS ARK, KP GARDEN STREET, MADHAVARAM HIGH ROAD, MADHAVARAM Chennai- 600 051. Land Mark : Next to ICICI Bank Madhavaram Branch. Share your CV to hr@acpbillingservices.com / WhatsApp 9841820311

We Are Hiring || AR Callers ( RCM US Healthcare ) || Experience :- Min 1 year of exp in AR Calling (US Health Care) into Denial Management Package :- Up to 50K Take home Locations :- Hyderabad , Banglore. Qualification :- Graduation. Perks and Benefits: 1. 2 way cab 2. Incentives and Allowances Notice Period :- Preferred Immediate Joiners ( Serving Notice period Candidates are also Eligible ) *Work From Office* Interested candidates can share your updated resume to HR Vaishnavi- 7386370056(share resume via WhatsApp ) Refer your friend's / Colleagues

Quantuspro Solutions is seeking a candidate with good analytical skills with understanding of US Health care/ Revenue Cycle Management/Accounts Receivables/ Claims processing. **EXCELLENT COMMUNICATION SKILLS IN ENGLISH IS VERY IMPORTANT** ** FRESHERS ARE WELCOME ** Job Description: - US Healthcare / Dental Billing Process - Accounts Receivables Calls - Denials and Appeals Management - End to End Billing Cycle Management - Posting Payments - Knowledge of Provider Credentialing - Knowledge of Insurance Eligibility verification - Knowledge in Dental Billing is a Plus - Excellent Communication Skills - Must be flexible to work in Day / Night Shifts - Good Typing Speed - Must be willing to work in Voice / Non-voice process Day Shift timings: 9 AM to 6 PM (IST) Night Shift timings: 8: 30 PM to 5: 30 AM (IST) FRESHERS ARE WELCOME ** Candidates with no experience but excellent communication, analytical skills, computer skills may also apply for this position. For further details please contact 7801017313/04035683890 Regards, HR Team Quantuspro Solutions

Software Engineers are responsible for the design, development, maintenance, testing and evaluation of a new or modified software product. They are responsible for the entire application lifecycle from research and design to implementation, training and support. Hands on experience working with enterprise level application is desired and eager to learn new technologies as per the need. A Software Engineer will work tightly with their team in understanding requirement and project timelines. Working with other engineers to ensure best practices, adherence to software standards and sound technical decisions are made and implemented while ensuring that software designs adhere to the architecture design and department standards. Duties & Responsibilities Be a champion for department initiatives and values ensuring all actions promote the department’s mission statement Determine operational feasibility by evaluating analysis, problem definition, requirements, solution development, and proposed solutions Work with other developers, analysts, project managers, QA and others to develop enterprise-level software products adhering to best practices and established standards and practices Ensure software solutions are reviewed, documented and unit tested prior to handing it over to QA Prepare and install solutions by determining and designing system specifications, standards, and programming Document and demonstrate solutions by developing documentation, flowcharts, layouts, diagrams, charts, code comments and clear testable code Improve operations by conducting systems analysis and recommending changes in policies and procedures Communicate in a professional manner when interacting with coworkers and external customers Participate in internal and external technical reviews, as required Other duties and projects as assigned Skills Required Robust understanding of OOPS and design patterns Ability to work independently and as part of a team Excellent time management, resource organization and priority establishment skills, and ability to multi-task in a fast-paced environment Can work quickly and efficiently with moderate supervision Demonstrated skills and abilities needed to coordinate, facilitate, and participate in a collaborative approach to the completion of tasks or assignments Ability to develop software in C#/.NET, WebAPI, Entity Framework, Angular 2/above, HTML/CSS, TSQL Strong knowledge of enterprise computing software, including system management standards and solutions Strong Object-Oriented design and implementation skills Understanding of NuGet package management including creation, deployment, and version management Good to have knowledge on Cloud services (Azure) Good to have knowledge on CI/CD Qualifications Have HEART. To work here, you must be: Humble– self-aware and respectful Effective– measurably move the needle& immeasurably add value Adaptable– innately curious and constantly changing Remarkable– stand out in some way Transparent– openly and honestly sharing knowledge 3 to 4 years’ experience with software development post BE/B.Tech, ME/M.Tech or MCA Must have hands on experience in the development of enterprise class software solutions Should have worked with Scaled Agile Framework About Symplr We are an industry leader in compliance, credentialing and workforce management software as a service solution. We help healthcare organizations mitigate risk, ensure compliance and optimal deployment of workforce. symplr has a single mission: to make healthcare compliance, credentialing and workforce management simpler for all constituents of the healthcare community. We’re recognized for our innovative and easy-to-use software as a service solution, as well as our payor enrollment services both of which significantly reduce the cost of compliance and increase operational efficiency. We’re based in the five major healthcare technology hubs in the US: Houston, Nashville, Kansas City, Hartford and Bangalore. We proudly serve well over 4,000 healthcare organizations, from the smallest surgery centers to the largest integrated delivery networks (IDNs) and payers nationwide. Show more Show less

🚀 Job Title: Provider Credentialing Specialist 📍 Location: Mohali (Remote/Hybrid) 📄 Job Type: Full-time 🧑‍💻Experience: 1-5 Years 🏢 Company Description RevGroMD enables growth in healthcare practice by providing expert revenue solutions. We navigate the complexities of provider enrollment, revenue cycle, and market dynamics so that you can focus on providing exceptional care. Our trio of essential services includes Insurance Credentialing, Revenue Cycle Management, and targeted Marketing Services to fortify your healthcare practice or facility. 🎯 Role Description This is a full-time remote role for a Provider Credentialing Specialist based in Mohali. The Provider Credentialing Specialist will be responsible for managing the provider enrollment process, ensuring accurate and timely completion of credentialing applications, and maintaining credentialing files. They will also collaborate with internal teams and insurance companies to resolve any credentialing issues and ensure compliance with Medicare and other regulatory requirements. 🔍 Key Responsibilities ✔ Review and authenticate credentials, qualifications, licenses, certifications, and other relevant documents submitted by individuals or organizations. ✔Take care of the provider's CAQH account, PECOS (Medicare Account), & application enrollment with Medicare & Medicaid. ✔ Complete and submit applications to insurance payers (Medicare, Medicaid, commercial payers). ✔ Track application progress and follow up regularly with insurance companies regarding provider enrollment status until completion. ✔ Maintain and update credentialing files and databases. ✔ Ensure compliance with HIPAA and industry regulations and standards. ✔ Collaborate with internal teams to resolve credentialing-related issues. 📌 Qualifications & Skills ✔ 1-5 years of hands-on experience in provider credentialing or payer enrollment ✔ Familiarity with CAQH, NPPES, PECOS, and payer portals ✔ Knowledge of end-to-end provider enrollment process ✔ Knowledge of Medicare, Medicaid, and commercial insurance enrollment processes ✔ Excellent written and verbal communication skills ✔ Strong organizational skills and attention to detail ✔ Proficiency with Google Workspace, credentialing software/tools, and project management tools 🤷 Why Join RevGroMD ✅Be part of a mission-driven team simplifying healthcare operations ✅Growth opportunities and skill development ✅Flexible work environment with ownership of your work ✅Make a direct impact on revenue cycle performance and provider satisfaction Show more Show less

We are pleased to inform you that we are organizing a Mega Walk-In Drive at our Bangalore office starting from 5 PM onwards for Exp AR Callers. Min 1 to 5+ yrs of experience Work from Office Required Candidate profile Immediate Joiners are preferred 2-Way Cab Facility Food provided Health insurance Job Location : Bangalore @ Chennai Email: manijob7@gmail.com Call or Whatsapp 9989051577

1. Location : Chennai & Bangalore 2. Exp : 1 - 4 Years exp in AR process and Denial management 3. Salary : Upto 47k take home 4. Interview mode : Virtual (online) 5. PF Account is mandatory 6. Shift t: Night Shift Required Candidate profile Knowledge of denials management and AR fundamentals is preferred. Experience in end-to-end RCM is preferred. Email: manijob7@gmail.com Call or Whatsapp 9989051577

Company Description SpeedBirdServices is a medical billing company located in Ahmedabad, providing efficient revenue cycle management solutions to healthcare providers. With over 10 years of experience, we offer personalized services tailored to meet the specific needs of each client, ensuring improved cash flow and less office distractions. Our services include E/M management, medical billing, medical coding, A/R management, referral and authorization management, and credentialing services. We also offer consultative services such as reviewing insurance contracts and optimizing super-bills. Role Description This is a full-time on-site role for a Medical Biller at SpeedBirdServices in Ahmedabad . The Medical Biller will be responsible for managing billing, collections, and other revenue cycle management tasks to ensure the practice's financial stability. Daily tasks may include handling medical terminology, denials, ICD-10 coding, insurance billing, and Medicare billing. Qualifications Medical Terminology and ICD-10 coding knowledge Experience with denials management and insurance billing Familiarity with Medicare billing processes Excellent attention to detail and organizational skills Strong analytical and problem-solving abilities Effective communication and interpersonal skills Certification in medical billing or related field is desirable Prior experience in revenue cycle management is a plus Education: UG :B.Sc in Any Specialization, Diploma in Any Specialization, B.Pharma in Any Specialization, B.B.A/ B.M.S in Any Specialization, B.Com in Any Specialization. Minimum Experience : 1 - 3 years Package : ₹ 2,00,000 - 4,00,000 P.A. Show more Show less

Verisys is looking for a QA lead who can ensure that software developed meets the standard of highest quality. This role requires leading a group of QA members, collaboration with various departments and developing testing strategies to build robust software products Duties/Responsibilities: Lead, mentor and guide a team of QA members to build the culture and excellence Apply business and functional knowledge to develop testing strategies Actively participate in product related meetings and contribute in complex discussion Participates in peer reviews of test cases to ensure quality and coverage of features Develop and implement quality metrics for process improvements Lead functional, integration, system, load and regression testing efforts Collaborate with Development , product and designers to identify test requirements and remove blockers Identifies opportunities for automation and lead the effort at organizational level Ready to work individual contributor in case required for a project Required Skills/Abilities: 8+ years of experience in software testing/development. Bachelor’s degree in computer science, Information Technology, or related field. Strong knowledge in software testing methodologies particularly in API and data related testing Proficiency in SQL and NoSQL databases. Experience in Selenium ,Playwright , Jenkins and Python for automation testing Exposure to Agile methodologies Experience in Test management tools like Azure Devops, Jira Good verbal and written communication, Analytical and problem solving Knowledge of DevOps functions and to contribute to CI / CD pipelines Preferred: Knowledge of one object oriented programming language. Familiarity with credentialing and/or healthcare is preferred Verisys transforms provider data, workforce data, and relationship management. More than 400 healthcare, life science, and background screening organizations depend on us to credential providers, improve data quality, publish compliant provider directories, and conduct employment verifications. Our comprehensive solutions deliver accurate and secure information. As a result, we’re the largest outsourced credentials verification organization in the United States. Since we’ve partnered with the most complex institutions in healthcare for decades, we can help organizations of any size discover their true potential. At Verisys, you can have a rewarding career on every level. In addition to challenging and meaningful work, you will have the chance to give back to your community, make a positive impact on the environment, participate in a range of diversity and inclusion initiatives, and find the support, coaching, and training it takes to advance your career. Our commitment to individual choice lets you customize aspects of your career path, your educational opportunities, and your benefits. And our culture of innovation means your ideas on how to improve our business and our clients will be heard. Verisys is an Equal Opportunity Employer. We encourage all qualified person of every heritage, nation, gender, veteran, or disability status, age, religion, or other protected status to apply. Show more Show less

About Certify: At CertifyOS, we're building the infrastructure that powers the next generation of provider data products, making healthcare more efficient, accessible, and innovative. Our platform is the ultimate source of truth for provider data, offering unparalleled ease and trust while making data easily accessible and actionable for the entire healthcare ecosystem. What sets us apart? Our cutting-edge, API-first, UI-agnostic, end-to-end provider network management platform automates licensing, enrollment, credentialing, and network monitoring like never before. With direct integrations into hundreds of primary sources, we have an unbeatable advantage in enhancing visibility into the entire provider network management process. Plus, our team brings over 25+ years of combined experience building provider data systems at Oscar Health, and we're backed by top-tier VC firms who share our bold vision of creating a one-of-a-kind healthcare cloud that eliminates friction surrounding provider data. But it's not just about the technology; it's about the people behind it. At Certify, we foster a meritocratic environment where every voice is heard, valued, and celebrated. We're founded on the principles of trust, transparency, and accountability, and we're not afraid to challenge the status quo at every turn. We're looking for purpose-driven individuals like you to join us on this exhilarating ride as we redefine healthcare data infrastructure. ABOUT THE ROLE: As Certify scales, we need to add rigor & structure to our operational processes to continue driving high customer satisfaction at increasingly attractive unit economics. We’re looking to hire an Quality Assurance Team Lead to lead a critical pod of our Quality team – someone who combines best-in-class people leadership with strong subject matter expertise and a relentless focus on speed & quality. This individual will oversee a production-focused pod made up of quality auditors (QAs). WHAT YOU’LL DO: People Management & Team Leadership You’ll be the direct manager for a team that is responsible for hitting daily and weekly targets, constantly driving towards improved performance of our file processing even as volume grows Initially, several auditors will report to you; you will be responsible for their growth paths and success in their roles, focusing on both individual and team metrics You will hold weekly 1:1 meetings with the quality auditors on your team to review topics like: their file review throughput, blockers they are facing, ideas for improvement, and their career growth. You will lean in with lower-and-middle performers to coach them on ways to improve their file quality and productivity During company performance reviews, you will coordinate with Operations Management to determine performance ratings for the QAs on your team and you will deliver performance review conversations for your team members Every day you will host a standup with your team to cover yesterday’s performance and the plan for today, and on a weekly basis you will review performance from the last week with the team You’ll also act as a liaison between the audit team and credentialing, compliance, and operations departments to resolve complex cases and maintain compliance Collaborate with the Credentialing Team leaders and internal stakeholders to develop, implement, and refine audit tools, workflows, and standard operating procedures. You will also help to develop and maintain documentation for training and audit protocolsOther focus areas will include: working to help onboard new hires; educating and supporting new team members as they train, and eventually you will be involved in the hiring process for new QAs who join your team Production Management You will be responsible for overseeing the daily operations, performance, and continuous improvement efforts of a team that audits credentialing files to ensure compliance with regulatory (i.e. CMS), accreditation (i.e. NCQA), and internal quality standards You will be accountable for the team hitting the core performance metrics for all clients. Your core metrics will be split across speed and quality. You will be obsessing over ways to improve each of these as volume scales Ultimately, you will be focused on ensuring that the files your team is responsible for are within SLA for all clients, and that the quality of the files is above and beyond expectations Every day you will ensure your team’s work has been effectively distributed to the QAs and that they are unblocked. You will coordinate with Credentialing Management to understand what the highest priority files are and ensure that your team is equipped to work on them You will review the data of your team’s performance on a daily and weekly basis, sharing information upwards to management, downwards to the team, and laterally to your peers You will Identify trends, gaps, and root causes in credentialing errors and work with process owners to improve quality WHAT YOU’LL NEED: Incredible coaching skills; you’re someone who is energized by mentoring and developing highly productive and happy team members A passion for seeing metrics improve week over week A desire to get deep in the weeds to understand how processes function and how they’re connected to driving key company metrics An ability to get your hands dirty and build, being tactical for the short term and strategic for the long termExtreme organizational skills A strong track record of juggling multiple initiatives and clear ability to prioritize the most important things At least 1 - 2 years in a quality assurance or auditing role, plus prior leadership or team coordination experience. Experience in healthcare credentialing is preferred At Certify, we're committed to creating an inclusive workplace where everyone feels valued and supported. As an equal opportunity employer, we celebrate diversity and warmly invite applicants from all backgrounds to join our vibrant community. Show more Show less

Skills: Next.js, React, JavaScript, HTML5, CSS3, react ecosystem, React Router, React Hooks, About The Job TL;DR: Seeking an experienced Front-end Developer proficient in React and Next.js to build user-friendly interfaces for Proof of Skill, a blockchain-based protocol for skill verification and credentialing. Proof of Skill protocol is a decentralised system where industry experts (Validators) evaluate candidates' skills and issue verifiable Skill Credentials. Organizations can then shortlist candidates based on these credentials. Please fill this form - forms.gle/th34vWx247XKsMXx9 Qualifications And Skills 5+ years of experience in front-end development, with a strong focus on React and Next.js Proficiency in JavaScript, HTML5, CSS3, and related front-end technologies Solid understanding of React ecosystem, including Redux, React Router, and React Hooks Experience with Next.js and its server-side rendering (SSR) and static site generation (SSG) capabilities Familiarity with modern front-end build tools and workflows (e.g., Webpack, Babel, ESLint) Knowledge of responsive design and cross-browser compatibility Experience with RESTful APIs and integration with back-end services Familiarity with web accessibility standards (WCAG) and best practices Understanding of blockchain technology and decentralized applications (dApps) is a plus Responsibilities Design and develop user-friendly interfaces for the Proof of Skill platform using React and Next.js Implement reusable and modular front-end components following best practices Integrate with blockchain-based back-end services and decentralized data sources Optimize performance, scalability, and security of the front-end applications Collaborate with the design team to ensure pixel-perfect implementation of UI/UX designs Write clean, maintainable, and well-documented code Participate in code reviews and ensure adherence to coding standards Stay up-to-date with the latest front-end technologies, frameworks, and industry trends Ideal Candidate Traits Strong problem-solving and analytical skills Excellent communication and collaboration abilities Attention to detail and commitment to writing clean, efficient code Passion for creating intuitive and engaging user experiences Entrepreneurial mindset and willingness to take ownership Curiosity and eagerness to learn and grow in a dynamic environment Experience building for crypto is a huge plus Show more Show less

Company Description RevGroMD enables growth in healthcare practice by providing expert revenue solutions We navigate the complexities of provider enrollment, revenue cycle, and market dynamics so that you can focus on providing exceptional care Our trio of essential services includes Insurance Credentialing, Revenue Cycle Management, and targeted Marketing Services to fortify your healthcare practice or facility Role Description This is a full-time role for a Provider Credentialing Specialist based in Mohali The Provider Credentialing Specialist will be responsible for managing the provider enrollment process, ensuring accurate and timely completion of credentialing applications, and maintaining credentialing files They will also collaborate with internal teams and insurance companies to resolve any credentialing issues and ensure compliance with Medicare and other regulatory requirements Qualifications ??Excellent organizational and communication skills ?? Review and authenticate credentials, qualifications, licenses, certifications, and other relevant documents submitted by individuals or organizations ??Follow Up with the insurance on provider enrollment ??Taking care of the provider's CAQH account, PECOS (Medicare Account), & application enrollment with Medicare & Medicaid ??Ability to work independently Show more Show less

Job Title- Executive - AR ( Credentialing ) Job Description As a Credentialing Associate at R Systems, you will play a pivotal role in ensuring the accurate and timely processing of credentialing applications for US healthcare professionals. Your expertise in regulatory compliance, attention to detail, and ability to manage multiple tasks will be critical in maintaining provider records and ensuring adherence to industry standards. You will conduct thorough background checks, verify licenses and certifications, and collaborate with internal teams to address credentialing issues. Additionally, you will stay informed about changes in healthcare regulations and help refine credentialing policies and procedures to enhance operational efficiency. Your contribution will directly impact the quality of healthcare services by ensuring that only qualified professionals are credentialed. Roles & Responsibilities Oversee credentialing processes, ensuring compliance with industry and regulatory standards. Collect, review, and verify documentation such as licenses, certifications, and work history. Maintain and update credentialing databases with accurate and current provider information. Track credentialing status, expirations, and re-credentialing timelines using software tools. Act as the primary contact for healthcare providers, guiding them through the credentialing process. Collaborate with internal teams, including HR and legal, to ensure credentialing requirements are met. Conduct audits to identify areas for improvement and ensure compliance with policies. Prepare detailed reports on credentialing activities and outcomes for leadership review. Stay current with state and federal regulations to ensure compliance. Assist in developing and implementing credentialing policies aligned with best practices and organizational standards. If you have relevant experience please drop your CV at naresh.arya@rsystems.com

US Healthcare Credentialing RCM Voice Process Remote Night Shift

Job Title Executive - AR ( Credentialing ) Job Description As a Credentialing Associate at R Systems, you will play a pivotal role in ensuring the accurate and timely processing of credentialing applications for US healthcare professionals. Your expertise in regulatory compliance, attention to detail, and ability to manage multiple tasks will be critical in maintaining provider records and ensuring adherence to industry standards. You will conduct thorough background checks, verify licenses and certifications, and collaborate with internal teams to address credentialing issues. Additionally, you will stay informed about changes in healthcare regulations and help refine credentialing policies and procedures to enhance operational efficiency. Your contribution will directly impact the quality of healthcare services by ensuring that only qualified professionals are credentialed. Roles & Responsibilities · Oversee credentialing processes, ensuring compliance with industry and regulatory standards. · Collect, review, and verify documentation such as licenses, certifications, and work history. · Maintain and update credentialing databases with accurate and current provider information. · Track credentialing status, expirations, and re-credentialing timelines using software tools. · Act as the primary contact for healthcare providers, guiding them through the credentialing process. · Collaborate with internal teams, including HR and legal, to ensure credentialing requirements are met. · Conduct audits to identify areas for improvement and ensure compliance with policies. · Prepare detailed reports on credentialing activities and outcomes for leadership review. · Stay current with state and federal regulations to ensure compliance. · Assist in developing and implementing credentialing policies aligned with best practices and organizational standards. Show more Show less

Hi All, We Infinx healthcare hiring Quality Auditors for Credentialing process, interested candidates can share resume to lakshmi.kavarthapu@infinx.com JD: Minimum 4yrs experience in Credentialing process. Senior Associates can also apply Specialty: Credentialing Designation: Quality Analyst Exp-4 to 8yrs Work from Office Hitech City location Regards, HR Team.

· Responsible for overseeing end to end Clinical tasks at Emergency Department. · Responsible for overseeing the assessment and immediate care for patients attending the Emergency Department and linked Emergency Care Network. · Will formulate initiate the plan of care for cases that come or referred ER. · Will formulate a plan to coordinate with all the departments in the hospitals for faster quick functioning of ER Cases. · Guide and also assist team on clinical skills to manage patient in ER. · Guide and assist all ER Staff on documentation, clinical skills and communication. · Ensure all medico legal documentation is completed in line with existing and current statutory requirements. · Plan to assist and train all ER Staff during code blue or code red alert. · Exercising principles of safety. · Participate in outreach clinics/ programs as and when required. · Practice Infection Control techniques and evidence based practice. · Develop, maintain, update and implement departmental policies, procedures and protocols. · Ensure provides are aware of and compliant with departmental, hospital and medical staff policies. · Perform quality assurance and lead improvement initiatives within the department. · Provide input into the operating and capital budget of the department. · Monitor patient experience and patient flow. Design and implement process improvement strategies to improve and optimize these areas. · Prepare for and participate in accreditation or certification surveys involving the ED. · Investigate and respond to patient complaints or grievances related to patient care. · Work to ensure effective communication between ED physicians and other hospital medical staff. · Ensure appropriate credentialing, orientation and training of providers in compliance with hospital policies and consistent with departmental needs. Job Type: Full-time Pay: ₹70,000.00 - ₹120,000.00 per month Schedule: Rotational shift Ability to commute/relocate: Basavanagudi, Bengaluru, Karnataka: Reliably commute or planning to relocate before starting work (Preferred) Experience: total work: 2 years (Preferred) Work Location: In person

Job Description - AR caller Minimum 1 year of experience Must worked in physician billing -CMC1500 Should have knowledge in Denials Immediate - 15 days preferable US Shift Transportation available (Within 20 km) Required Candidate profile Face to Face rounds at Bangalore @ Chennai Should have worked on appeals, AR Follow-up, refiling & denial management Job Location: Bangalore Email: manijob7@gmail.com Call / Whatsapp 9989051577

Company Profile: Digital Harbor, Inc., a V irginia, US- product based company , is a pioneer in enterprise innovation, with several firsts including the global norm ‘Know Your Customer’ (KYC) in its credit. Its oeuvre, for last 20 years, is marked with disruptive platforms and products that have transformed the way enterprises operate. Its ‘ Know Your Provider’ (KYP) has revolutionized how healthcare provider credentialing functions, thus bringing unprecedented risk-control and compliance in the US public healthcare system. Its current focus is on a future-incubating platform ‘Social Enterprise Technology’ (S.E.T.), built to catapult enterprises into transformational trajectories through Conversational Applications, a first-of-its-kind human-literate applications. We were ranked among the top 500 fastest growing technology companies in North America by ‘Deloitte Fast 500’ – 2018. Our products won ‘Most Innovative Product of the Year – 2018’ and ‘BIG Innovation Award – 2019’. Digital Harbor was voted by employees as “Best Place to Work” in 2018 & 2019. Yes, everything! Role: Director of Engineering(Java) Job Location: Bangalore (Marathahalli) Work Mode: 5 days work from office Job description: • The role requires a significantly experienced and confident professional with relevant full product lifecycle capabilities. • This role is for a next generation Enterprise Technology Platform. • The role demands that the Engineering Leader understands the existing platform which has been built with a substantial investment and take it to the next level to build cutting edge solutions for our customers. • The platform is the core part of the solution for our embedded analytics solution which enable our partners and customers to derive substantial value from a SaaS based engagement. Key Result Areas: • Create detailed technical task lists, provide technical guidance to the team, and enforce Digital Harbor standards and best practices • Devise innovative approaches for delivering tailored solutions leveraging advanced domain knowledge, technology competency and industry exposure. • Establish & develop strong professional relationships with Product Management, Analytics and Technology groups and acts as the Engineering anchor. • Collaborate with technical developers; review deliverables for accuracy, quality, application performance, and completeness. • Provides in-depth and sophisticated analysis with interpretive thinking to define problems and develop innovative solutions • Create/enhance reusable assets & frameworks. • Develop prototypes to demonstrate illustrate the use of new technologies within our Products. • Contribution to the strategic vision of Digital Harbor’s Platform product. • Leading Engineering team by provide strong technical leadership and guidance When we come face to face, we’d like to understand what you’ll have done as a Director of Engineering superhero in your past experience. Job Requirement: • MUST demonstrate a history of successfully building functionally rich, high performance, scalable and multi-tenant platforms. • Solid experience in building secure platforms. • A substantial track record of success in bringing innovative software products to market is a MUST. • Very strong background in Java technologies. • Understands platform, challenges in platform development and a proven capability to articulate platform level abstractions from user requirements. • Capability to do a SWOT on internal tools and 3rd party tools and provide a clear decision in terms of the approach • Ability to maintain ‘big picture’ focus and lead engineering in a rapidly evolving technology marketplace. • Enterprise platform experience with preferably both thin and thick client experience • Has a passion for building applications that are sensitive to memory, bandwidth, latency and tough performance constraints. Has relevant metrics to talk about it. • Work and collaborate with a talented team in a highly agile Scrum environment. • Deeply conversant in technologies like Java/J2ee, Java Script, XML, DOM/SAX Parsers, Swings, HTML, CSS, HTTP/s, C++, Jboss, JSP, EJB 2.0, Struts 2.0, Servlets, Kodo (ORM), JMS, RMI, Quartz, ANT, drools, various file Systems, XML, DB (SQL, Oracle, DB2), DMS, Web Services, LDAP integration. • Has built or integrated tools like Document Management System, Work Flow management, Offline Capability, Integration frameworks. • Strong knowledge of SQL, Relational databases and Data Modeling. Knowledge of distributed systems, concurrency, scalability, and fault tolerant designs. • Strong verbal, presentation and written communications skills for technical audiences; able to explain and drive technical solutions to technical teams; highly persuasive, Outstanding leadership and team-building skills. • Good planning and organizational skills, with self-initiative and direction. Has AGILE experience Desired Soft skills • Passion to work for small and high growth Organizations. • Self-starter who is hungry to take on new professional challenges and looking for roles with enormous growth potential. • Self-motivated and believes in getting things done. • Reliable, Trustworthy and possesses Professional Integrity. • Stable job history; Startup/entrepreneurial experience a real plus. We’re sure that you’re creative, move mountains with a tactful spoon, and whatnot, so why wait? We want to meet you! Show more Show less

Job Title : HR Business Partner (HRBP) – EVEN Hospital , Race Course Road Department : Human Resources Reporting To : Head – Human Resources / Hospital Director Location : Race course Road, Bangalore Experience : 8–12 years in HR, preferably in healthcare/hospital sector Job Summary The HR Business Partner will serve as a strategic partner to clinical and non-clinical departments, aligning HR strategies with hospital goals. The role involves talent management, employee engagement, workforce planning, HR operations, compliance, and policy implementation, ensuring a high-performance and patient-centric culture. Key Responsibilities Strategic HR Partnership : Collaborate with hospital leadership and department heads to align HR initiatives with hospital strategy. Act as a change agent for organizational transformation and continuous improvement. Support in organizational design, restructuring, and culture-building initiatives. Talent Management & Workforce Planning Drive end-to-end recruitment for clinical and non-clinical roles in coordination with Talent Acquisition team. Conduct manpower planning, budgeting, and forecasting. Facilitate onboarding, orientation, and timely deployment of staff. Employee Relations & Engagement Address grievances, manage disciplinary actions, and support conflict resolution. Design and execute employee engagement programs to boost morale and retention. Act as a point of contact for doctors, nurses, paramedics, and administrative staff for HR-related issues. Performance Management Facilitate goal-setting, appraisals, and performance discussions across functions. Support leadership in identifying high performers and succession planning. Implement development plans for underperforming staff in collaboration with Learning & Development. Learning & Development Assess training needs, especially for clinical compliance, soft skills, and leadership development. Coordinate CMEs, workshops, and professional development programs. Ensure mandatory trainings (e.g. BLS, infection control) are conducted regularly. HR Operations & Compliance Ensure timely processing of payroll inputs, leaves, attendance, and HRIS data accuracy. Ensure adherence to statutory compliances (PF, ESI, maternity leave, etc.). Monitor contract staff/vendor compliance in coordination with Admin/Operations. Hospital-Specific HR Initiatives Coordinate with Quality/Accreditation teams (NABH/NABL) for HR documentation and audits. Manage credentialing and privileging processes of doctors and consultants. Support medico-legal preparedness from HR side (training, documentation, etc.). Key Skills & Competencies Strong interpersonal and communication skills. Ability to influence stakeholders and drive change. Knowledge of labor laws, HR best practices, and hospital-specific regulatory standards. High emotional intelligence and conflict resolution skills. Data-driven decision-making and proficiency in HR analytics. Qualifications MBA/PGDM in Human Resources or equivalent. Preferred: Certification in Hospital Administration or Healthcare HR. Experience in a JCI/NABH-accredited hospital is an advantage. Skills: workforce analytics,talent management,workforce planning,compliance,performance management,policy implementation,hr operations,employee relations,change management,interpersonal skills,regulatory compliance,knowledge of labor laws,learning & development,hr analytics,employee engagement,conflict resolution Show more Show less

· Responsible for overseeing end to end Clinical tasks at Emergency Department. · Responsible for overseeing the assessment and immediate care for patients attending the Emergency Department and linked Emergency Care Network. · Will formulate initiate the plan of care for cases that come or referred ER. · Will formulate a plan to coordinate with all the departments in the hospitals for faster quick functioning of ER Cases. · Guide and also assist team on clinical skills to manage patient in ER. · Guide and assist all ER Staff on documentation, clinical skills and communication. · Ensure all medico legal documentation is completed in line with existing and current statutory requirements. · Plan to assist and train all ER Staff during code blue or code red alert. · Exercising principles of safety. · Participate in outreach clinics/ programs as and when required. · Practice Infection Control techniques and evidence based practice. · Develop, maintain, update and implement departmental policies, procedures and protocols. · Ensure provides are aware of and compliant with departmental, hospital and medical staff policies. · Perform quality assurance and lead improvement initiatives within the department. · Provide input into the operating and capital budget of the department. · Monitor patient experience and patient flow. Design and implement process improvement strategies to improve and optimize these areas. · Prepare for and participate in accreditation or certification surveys involving the ED. · Investigate and respond to patient complaints or grievances related to patient care. · Work to ensure effective communication between ED physicians and other hospital medical staff. · Ensure appropriate credentialing, orientation and training of providers in compliance with hospital policies and consistent with departmental needs. Job Type: Full-time Pay: ₹70,000.00 - ₹120,000.00 per month Schedule: Rotational shift Ability to commute/relocate: Basavanagudi, Bengaluru, Karnataka: Reliably commute or planning to relocate before starting work (Preferred) Experience: total work: 2 years (Preferred) Work Location: In person

Job Description We are seeking an experienced and detail-oriented Certification Exam Development Manager to lead the design, development, and maintenance of certification exams that uphold the highest standards of validity, reliability, and fairness. This role is critical in ensuring Oracle industry-recognized professional certifications accurately assess candidate competencies. Career Level - IC3 Responsibilities About Oracle University Oracle University (OU) is committed to providing world-class training and an unbeatable educational experience. OU focuses on delivering superior training that enhances the adoption of Oracle technologies. As one of the largest corporate training organizations in the world, OU helps make technology strategies successful with the help of complete, flexible, and customized learning solutions that are delivered globally. The goal is to provide every OU student with a highly engaging learning experience through a range of learning products and services. Roles And Responsibilities Manage the end-to-end exam development process for Oracle Cloud Applications and Oracle Cloud Infrastructure on Oracle MyLearn and Oracle Cloud Success Navigator platforms Contribute to all aspects of high-impact certification projects from start to finish, working in close collaboration with product development engineering, consultants, partners, instructional designers, psychometricians, and other Subject Matter Experts (SMEs) Define the intent and scope of exams for specific target audiences and job roles Perform Job Task Analysis (JTA), create exam blueprint design Manage item banks, blueprint development, and psychometric analysis to ensure test integrity and performance Conduct item review workshops and training sessions for SMEs and item writers Provide guidance and training on Oracle style guidelines and best practices for item writing Conduct item analysis and review statistical data to improve exam quality Manage multiple projects simultaneously, ensuring timely delivery of high-quality exam content Implement Certification industry standards and best practices in exam deliverables Stay up-to-date with latest trends and best practices in instructional design, certification exam development, and psychometrics Build a strong technical understanding of the product line to effectively engage with consultants, engineering teams, subject matter experts (SMEs), and instructors Own and drive the Go-to-Market strategy to ensure the success of certification exams To be successful in this role, we need someone who has: Experience in conducting Job Task Analysis, facilitating item writing workshops and training SMEs Knowledge of Certification development standards and models Experience in designing and developing exams Exceptional writing, editing, and proofreading skills Understanding of what it takes to produce candidate value in an exam Professionalism and confidence to defend exams, processes, and exam content Strong knowledge of psychometric principles and their application in exam development Excellent project management skills with the ability to manage multiple projects simultaneously Strong analytical skills with the ability to interpret complex data and make data-driven decisions Excellent written and verbal communication skills, with the ability to convey complex concepts clearly to diverse audiences Proven ability to work in a fast-paced environment with geographically distributed stakeholders Basic Qualifications Bachelor’s degree in Science or Engineering 5+ years of experience in certification exam development or credentialing, preferably in a tech or cloud-based environment Knowledge of certification industry standards and best practices Deep understanding of Oracle Cloud Applications (ERP, HCM, SCM, or CX) or experience working in the Oracle partner/customer ecosystem Previous experience with certification exams as an SME Technical writing and editing experience Any related-industry professional certification credentials Exposure to AI authoring/development tools Qualifications Career Level - IC3 About Us As a world leader in cloud solutions, Oracle uses tomorrow’s technology to tackle today’s challenges. We’ve partnered with industry-leaders in almost every sector—and continue to thrive after 40+ years of change by operating with integrity. We know that true innovation starts when everyone is empowered to contribute. That’s why we’re committed to growing an inclusive workforce that promotes opportunities for all. Oracle careers open the door to global opportunities where work-life balance flourishes. We offer competitive benefits based on parity and consistency and support our people with flexible medical, life insurance, and retirement options. We also encourage employees to give back to their communities through our volunteer programs. We’re committed to including people with disabilities at all stages of the employment process. If you require accessibility assistance or accommodation for a disability at any point, let us know by emailing accommodation-request_mb@oracle.com or by calling +1 888 404 2494 in the United States. Oracle is an Equal Employment Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability and protected veterans’ status, or any other characteristic protected by law. Oracle will consider for employment qualified applicants with arrest and conviction records pursuant to applicable law. Show more Show less

We are seeking an experienced and detail-oriented Certification Exam Development Manager to lead the design, development, and maintenance of certification exams that uphold the highest standards of validity, reliability, and fairness. This role is critical in ensuring Oracle industry-recognized professional certifications accurately assess candidate competencies. About Oracle University: Oracle University (OU) is committed to providing world-class training and an unbeatable educational experience. OU focuses on delivering superior training that enhances the adoption of Oracle technologies. As one of the largest corporate training organizations in the world, OU helps make technology strategies successful with the help of complete, flexible, and customized learning solutions that are delivered globally. The goal is to provide every OU student with a highly engaging learning experience through a range of learning products and services. Roles and Responsibilities: Manage the end-to-end exam development process for Oracle Cloud Applications and Oracle Cloud Infrastructure on Oracle MyLearn and Oracle Cloud Success Navigator platforms Contribute to all aspects of high-impact certification projects from start to finish, working in close collaboration with product development engineering, consultants, partners, instructional designers, psychometricians, and other Subject Matter Experts (SMEs) Define the intent and scope of exams for specific target audiences and job roles Perform Job Task Analysis (JTA), create exam blueprint design Manage item banks, blueprint development, and psychometric analysis to ensure test integrity and performance Conduct item review workshops and training sessions for SMEs and item writers Provide guidance and training on Oracle style guidelines and best practices for item writing Conduct item analysis and review statistical data to improve exam quality Manage multiple projects simultaneously, ensuring timely delivery of high-quality exam content Implement Certification industry standards and best practices in exam deliverables Stay up-to-date with latest trends and best practices in instructional design, certification exam development, and psychometrics Build a strong technical understanding of the product line to effectively engage with consultants, engineering teams, subject matter experts (SMEs), and instructors Own and drive the Go-to-Market strategy to ensure the success of certification exams To be successful in this role, we need someone who has: Experience in conducting Job Task Analysis, facilitating item writing workshops and training SMEs Knowledge of Certification development standards and models Experience in designing and developing exams Exceptional writing, editing, and proofreading skills Understanding of what it takes to produce candidate value in an exam Professionalism and confidence to defend exams, processes, and exam content Strong knowledge of psychometric principles and their application in exam development Excellent project management skills with the ability to manage multiple projects simultaneously Strong analytical skills with the ability to interpret complex data and make data-driven decisions Excellent written and verbal communication skills, with the ability to convey complex concepts clearly to diverse audiences Proven ability to work in a fast-paced environment with geographically distributed stakeholders Basic Qualifications: Bachelor’s degree in Science or Engineering 5+ years of experience in certification exam development or credentialing, preferably in a tech or cloud-based environment Knowledge of certification industry standards and best practices Deep understanding of Oracle Cloud Applications (ERP, HCM, SCM, or CX) or experience working in the Oracle partner/customer ecosystem Previous experience with certification exams as an SME Technical writing and editing experience Any related-industry professional certification credentials Exposure to AI authoring/development tools Show more Show less

Job Description: Thryve is hiring! We have an exciting opening for Fresher in US Healthcare, See the criteria below for our Fax Intake Coordinator (Apprentice) position. Company's Profile: Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers. Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients, which keeps the ever-evolving consumers engaged and assists them in managing the future of their healthcare better. We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. Thryve is an equal opportunity employer and places a high value on integrity, diversity, and inclusion in the organization. We do not discriminate based on any protected attribute. For more information about the organization, please visit www.thryvedigital.com Role Description: Role: Fresher (Apprentice) for initial 6 months Position: Non-Technical Skill: Fax Intake Coordinator Shift: Rotational Night Shifts(6:30 PM to 3:30 AM or 10:00 PM to 7:00 AM) Apprentice Stipend: 21,000 (for six months) + Medical Insurance 5,00,000 Post Apprentice: 3,25,000 /PA +Medical Insurance 5,00,000 + Conversion bonus 24,000/- Work Location: Hyderabad Work Mode: Onsite (all 5 days work from office) Education: Any Graduate (Engineering/Tech graduates are not preferred) Venue : Unit No - 601, Building Number 12D, 6th Floor, M/s Sundew Properties Ltd, IT/ITES SEZ, Mind space Hi-Tech City, Madhapur, Hyderabad - 500081. Walk-In Date: 07th Jun 2025, Saturday. Walk-In Time : 09:30 AM -11:00 AM Intake Coordinator is responsible for reviewing the fax that we receive and understand the medical terminology on each page of the fax. Should be able to identify the type of fax and provide authorization within TAT. Essential Responsibilities: Build cases based on the documentation on the fax after thorough review and complete the case build with in the TAT based on SLA. Ensure login timings are adhered to as the process is time-bound, and the TAT is 4-6 hours. Ensure cases are built based on updated and current tip sheets following all essential rules. To ensure quality and productivity is met based on our SLAs. Flexible enough to meet overtime requirements and take responsibility for delivering all cases assigned. Other job responsibilities as assigned from time to time. Other additional duties as assigned or requested. Requirements: Knowledge in US Healthcare with clinical orientation/experience claims, benefits, pre- authorization, Medical Coding, Enrollment with educational qualifications as mentioned. Good communication skills including listening, reading, and speaking with ability to communicate effectively. Ability to work in rotational shifts with rotational week offs and different US shifts/night shifts continuously. Ability to thrive in an environment of change and fluctuating priorities. Preferred: Knowledge on US Healthcare industry Ability to use independent judgement and critical thinking. Any Clinical certification

Job Description: Thryve is hiring! We have an exciting opening in US Healthcare, See the criteria below for our Fax Intake Coordinator position. Company's Profile: Thryve Digital Health LLP is an emerging global healthcare partner that delivers strategic innovation, expertise, and flexibility to its healthcare partners. Being a US healthcare conglomerate captive, we have direct access to deeper insights that help us accelerate our learning process and keeps us ahead of the curve. Thryve delivers next-generation solutions that enable our healthcare partners to provide positive experiences to their consumers. Our global collaborative of healthcare, operations, and IT experts creates innovative and sustainable processes for our clients, which keeps the ever-evolving consumers engaged and assists them in managing the future of their healthcare better. We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. Thryve is an equal opportunity employer and places a high value on integrity, diversity, and inclusion in the organization. We do not discriminate based on any protected attribute. For more information about the organization, please visit www.thryvedigital.com Role Description: Role: Process Analyst or Senior Process Analyst Position: Non-Technical Skill: Fax Intake Coordinator Experience: 1-2.5 Years (Any US Healthcare background) Shift: Rotational Night Shifts(6:30 PM to 3:30 AM or 10:00 PM to 7:00 AM) Work Location: Hyderabad Work Mode: Onsite (all 5 days work from office) Education: Any Graduate ( Engineering / Tech graduates are not preferred) Venue : Unit No - 601, Building Number 12D, 6th Floor, M/s Sundew Properties Ltd, IT/ITES SEZ, Mindspace Hi-Tech City, Madhapur, Hyderabad - 500081 Walk-In Date: 07th Jun 2025, Saturday. Walk-In Time : 09:30 AM -11:00 AM Intake Coordinator is responsible for reviewing the fax that we receive and understand the medical terminology on each page of the fax. Should be able to identify the type of fax and provide authorization within TAT. Essential Responsibilities: Build cases based on the documentation on the fax after thorough review and complete the case build with in the TAT based on SLA. Ensure login timings are adhered to as the process is time-bound, and the TAT is 4-6 hours. Ensure cases are built based on updated and current tip sheets following all essential rules. To ensure quality and productivity is met based on our SLAs. Flexible enough to meet overtime requirements and take responsibility for delivering all cases assigned. Other job responsibilities as assigned from time to time. Other additional duties as assigned or requested. Requirements: 1-2.5 years experience in US Healthcare with clinical orientation/experience claims, benefits, pre-authorization, Medical Coding, Enrollment with educational qualifications as mentioned. Good communication skills including listening, reading, and speaking with ability to communicate effectively. Ability to work in rotational shifts with rotational week offs and different US shifts/night shifts continuously. Ability to thrive in an environment of change and fluctuating priorities. Preferred: Knowledge on US Healthcare industry Ability to use independent judgement and critical thinking. Any Clinical certification