921 Credentialing Jobs - Page 33

Position Overview A Credentialing and Licensing Specialist plays a crucial role in verifying and maintaining professional credentials, particularly in healthcare and other regulated industries. Reporting to the Senior Manager C&L, this role involves registering nurses in the council, guidance for the Verification from college and council, tracking candidate progress until they have the license. Qualification: Bachelor's degree in a relevant field. Minimum of 1 year of experience in GCC registration process Experience in candidate coordination is preferred. Strong organizational skills and ability to manage multiple candidates simultaneously. Excellent English verbal and written skills to effectively engage with candidates and councils. Problem-solving mindset with the ability to address delays or candidate concerns proactively. Proficiency in CRM, ATS, and tracking/reporting tools to monitor candidate progress. Attention to detail and ability to ensure compliance with licensing requirements. Key Responsibilities Manage the registration of nurses with the Nursing councils in GCC. This includes creation and maintaining of the candidate registration in Mumaris+, Sharyan website, TAMM website etc , Data flow support, Support nurses with Exam booking if required Ensure candidates complete necessary steps, including council and college verifications, in a timely manner. Maintain regular communication with candidates to provide guidance and updates, minimizing disengagement or delays. Track each candidate’s progress using internal systems (e.g., CRM, ATS) and ensure data accuracy. Identify and escalate any issues or roadblocks that could delay registration. Maintain accurate and up-to-date records of candidate progress in tracking systems. Assist in identifying process inefficiencies and recommending improvements to enhance registration experience. Report on the candidate progression with the manager to track the efficiency Ensure adherence to standardized workflows and best practices established by the Operations Department

Graduate with Min. 10+ years of experience in US healthcare Provider enrollment, specific to Credentialing experience is mandatory. • More than 2+ year of experience as Manager/ Sr. Manager • Excellent spoken and written communication skills. • Should have good experience in Team management. • Should have experience in preparing KPI reports and interacting clients Key Responsibilities: • Manage and oversee the end-to-end credentialing process for Physicians, ensuring compliance with accreditation and regulatory requirements. • Oversee the credentialing and re-credentialing process for all healthcare providers, ensuring accuracy and timeliness in the submission of credentialing documents. • Ensure Compliance with Healthcare regulations, including HIPAA and Medicare/Medicaid rules. • Supervise and train Credentialing team, ensuring high productivity and efficiency. • Set goals for the team and implement best practices.

Overview: As a Credentialing Executive, you will play a crucial role in ensuring that our healthcare organization maintains compliance with regulatory standards and delivers high-quality care by thoroughly vetting and credentialing healthcare providers Your attention to detail, understanding of healthcare regulations, and ability to build strong relationships will be instrumental in facilitating the credentialing process and maintaining accurate provider databases. Responsibilities: Provider Credentialing: Manage the credentialing process for healthcare providers, including physicians, nurse practitioners, physician assistants, and allied health professionals This involves collecting, verifying, and evaluating provider credentials, licenses, certifications, and other relevant documents to ensure compliance with organizational and regulatory standards. Provider Enrollment: Coordinate provider enrollment with various insurance networks, Medicare, Medicaid, and other payer organizations Complete and submit enrollment applications accurately and in a timely manner to facilitate reimbursement for services rendered by credentialed providers. Database Management: Maintain accurate and up-to-date provider databases, including credentialing files, licensure information, malpractice insurance coverage, and other pertinent documentation Ensure that all provider information is entered and updated in credentialing software systems or databases. Regulatory Compliance: Stay abreast of changes in healthcare regulations, accreditation standards, and payer requirements related to provider credentialing and enrollment Ensure that credentialing processes align with industry best practices and regulatory guidelines, including those set forth by organizations such as NCQA, URAC, and CMS. Provider Relationships: Develop and maintain positive relationships with healthcare providers, medical staff, and internal stakeholders to facilitate the credentialing process Serve as a liaison between providers and credentialing committees, addressing inquiries, resolving issues, and providing support as needed. Quality Assurance: Implement quality assurance measures to monitor the effectiveness and efficiency of the credentialing process Identify areas for improvement and implement corrective actions to enhance process efficiency, accuracy, and compliance. Audits and Reviews: Prepare for and participate in internal and external audits, reviews, and accreditation surveys related to provider credentialing and enrollment Ensure that credentialing documentation and processes meet audit requirements and support organizational compliance. Training and Education: Provide training and education to healthcare providers and staff on credentialing policies, procedures, and best practices Foster a culture of compliance and accountability throughout the organization by promoting awareness of credentialing requirements and expectations. Qualifications: Bachelor's degree in healthcare administration, business administration, or a related field (Master's degree preferred). Certification in healthcare credentialing (e.g., CPCS, CPMSM) highly desirable. Minimum of 3-5 years of experience in healthcare credentialing and provider enrollment, preferably in a managed care. In-depth knowledge of healthcare regulations, accreditation standards, and payer requirements related to provider credentialing and enrollment (e.g., NCQA, CMS, Medicare). Proficiency in credentialing software systems (e.g., CAQH, NAMSS) and Microsoft Office Suite. Strong analytical skills with the ability to review and interpret complex credentialing documents and data. Excellent communication, interpersonal, and organizational skills. Detail-oriented with a commitment to accuracy and quality assurance. Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.

Job Summary We are seeking a Process Specialist with 4 to 5 years of experience in HealthCare Products to join our team. The ideal candidate will have expertise in Prov Privileges excl Hospital Demo Changes Credentialing and Re-credentialing by Calls . This role requires working in a hybrid model with night shifts. The candidate will play a crucial role in ensuring the smooth operation of healthcare processes and contribute to the overall efficiency and effectiveness of our services. Responsibilities Oversee the management of healthcare products to ensure compliance with industry standards and regulations. Provide expertise in Prov Privileges excl Hospital to maintain accurate provider information. Manage demo changes to ensure that all demographic data is up-to-date and accurate. Handle credentialing and re-credentialing processes to ensure that all providers meet the necessary qualifications and standards. Collaborate with various departments to streamline healthcare processes and improve overall efficiency. Conduct regular audits to ensure compliance with healthcare regulations and standards. Develop and implement process improvements to enhance the quality of healthcare services. Provide training and support to team members on healthcare processes and procedures. Monitor and analyze process performance to identify areas for improvement. Ensure that all healthcare processes are documented and maintained accurately. Work closely with healthcare providers to address any issues or concerns related to credentialing and privileges. Participate in the development and implementation of healthcare policies and procedures. Maintain up-to-date knowledge of industry trends and best practices in healthcare process management. Qualifications Possess a minimum of 4 years of experience in healthcare products management. Demonstrate expertise in Prov Privileges excl Hospital demo changes credentialing and re-credentialing. Have a strong understanding of healthcare regulations and standards. Exhibit excellent communication and collaboration skills. Show proficiency in process improvement methodologies. Display strong analytical and problem-solving abilities. Certifications Required Certified Provider Credentialing Specialist (CPCS) or equivalent certification is required. Show more Show less

About Us: As a pioneer in Healthcare, Manipal Hospitals is among the top healthcare providers in India serving over 5 million patients annually. Today we stand as an integrated network with a pan-India footprint of 37 hospitals across 19 cities with 10,500 beds, and a talented pool of over 5,600 doctors and an employee strength of over 20,000. Job Description Provides clinical and administrative direction for the clinical operation of medical departments and services. Responsible for the co-ordination and oversight of all medical care and support clinical related quality monitoring /accreditation/quality assurance. Roles & Responsibilities Responsible for overall co-ordination and oversight of all medical care provided at the unit and quality of clinical services rendered Ensure statutory compliances with regards to MTP, PCPNDT, AERB, Radiation Safety etc Analyze department mix and need for consultants Participate in tariff revision and clinical compensation patterns Analyze performance of retainers Monitor & Rationalize Doctor cost Rationalization of surgical & Medical Charges Responsible for the clinician / clinical related quality monitoring/accreditation /quality assurance services Co-ordinate and conduct medical Advisory Board, Clinical HOD Committee, departmental meetings. Participate and key contributor to Infection Control Committee, Pharmacy and Therapeutic Committee, Ethics Committee, Blood transfusion Committee, CPR analysis Committee. To Oversee reporting and communication of quality improvement initiatives, quality and patient safety awareness, safety culture survey administration, and recognition programs Addressing requirement of consultants and recruitment of consultants Induction, On boarding, Credentialing and privileging, formulating Contracts with inputs from Hospital Director for the new Consultants. Training and re privileging and monitoring performance and appraisal of the Consultants and maintaining personnel file with all the documents. Addressing any clinical governance related issues and initiating appropriate action when necessary Addressing of clinical Patient concerns/ complaints / potential medico legal complaints in coordination with treating Doctor. To review, peer review and formulate the draft reply for the medico legal cases with inputs from the treating team. Submit all documents and the draft version to the legal team. To maintain medicolegal tracker and follow up on active cases Conducting morality Mortality meetings periodically and review cases Audit-Clinical billing codes To provide clinical input to Unit Head whenever required for medico legal cases received Any new projects for MHEPL as per the Medical Admin with regard to clinical assessment To engage with the team through various initiatives like training, performance management, continual feedback, coaching and reward and recognize people to motivate them to deliver desired results Recommend junior clinical manpower for effective functioning of clinical departments Evaluate and initiate academic activities and programs like DNB/FNB/ Fellowship/ Training and certification Courses Ensure training of doctors on patient safety, service excellence initiatives and healthcare communication Prepare the biomedical equipment capital expenditure budget based on inputs from clinicians and biomedical department. Planning, rationalizing and optimizing the utilization of the equipment and providing inputs for procurement Oversight of medical records department and initiate digitization, Electronic records where feasible Conduct awareness programs, campaigns and drives for dissemination of service excellence initiatives, patient experience videos, effective communication strategies Medical Audits and facilitator of JCI/NABH Accreditation What We Are Looking For: Qualification : MBBS + MHA Minimum 2 years of experience in Medical Superintendent role. Proven team leadership skills with the ability to work effectively in a highly collaborative team environment. What We Offer: Competitive salary and benefits package Opportunities for professional development and career growth A collaborative and inclusive work environment How to Apply: Ready to make your mark with us? Apply now by sending your resume to rudra.chintapalli@manipalhospitals.com Show more Show less

Time: 6:00 pm to 3:00 am Location : Pune Balewadi Highstreet Key Responsibilities Supervise and mentor a team of credentialing specialists to ensure all credentialing and re-credentialing processes are completed accurately and on time. Maintain and monitor credentialing timelines and compliance with payer, hospital, and licensing requirements. Oversee the preparation and submission of initial and renewal credentialing applications for providers across Medicare, Medicaid, and commercial payers. Ensure timely updates and accuracy of provider data in CAQH, PECOS, NPPES, and other credentialing databases. Manage provider licensing renewals (e.g., state licenses, DEA, CDS) and revalidation processes. Collaborate closely with the Revenue Cycle and Billing teams to proactively address claim denials or authorization issues related to credentialing. Conduct regular audits of provider files and credentialing records to ensure full regulatory and payer compliance. Maintain and regularly update internal credentialing dashboards and provider grids for reporting. Act as a liaison with payers and healthcare institutions to resolve escalations or delays. Drive process improvements and implement best practices in credentialing workflows. Prepare credentialing reports for leadership and support in internal and external audits. Perform other duties as assigned by leadership. Serve as company liaison with 3rd party payers; Manage update to date information regarding fee schedules; Grow and manage a team of credentialing coordinators; Manage and update credentialing & clinic licensure policies and protocols; Ensure reports on credentialing status of providers is up to date and accurate; Define and implement processes to ensure credentialing is completed and up to date in a timely manner; Manage process of negotiating new insurance contracts; Ensure all clinic information is accurate within 3rd party payer directory; Drive and implement seamless protocols for gathering credentialing data from health care providers Show more Show less

The healthcare industry has embraced the digital revolution, and registered nurses (RNs) are now joining the remote workforce in increasing numbers. Today, RN Careers Work From Home are not only possible—they’re in demand. If you’re an RN seeking more flexibility, better work-life balance, or an opportunity to use your skills outside of a traditional hospital setting, this guide is for you. We’ll explore the best remote nursing careers in the U.S., how to qualify, where to apply, and how to transition to virtual nursing successfully. Why Choose a Remote Nursing Career? As the demand for healthcare professionals continues to rise, so does the need for telehealth and administrative nursing roles . Working from home as a nurse offers a unique blend of flexibility, autonomy, and meaningful patient interaction, without long shifts or commutes. ✅ Benefits Of Work-from-Home Nursing Jobs: Flexible schedules for better work-life balance Reduced stress and burnout No commuting or hospital exposure Diverse career paths in education, tech, insurance, and more Competitive pay with growth opportunities Who Can Work Remotely as an RN? Most remote nursing jobs require an active, unrestricted Registered Nurse (RN) license , and in many cases, additional experience in clinical settings or specialty areas. 📌 Common Requirements: Current RN license (multi-state compact license is a plus) 2–3 years of clinical experience Strong communication and tech skills HIPAA compliance knowledge A quiet home office setup Top Work-from-Home RN Careers in the U.S. Here’s a breakdown of the most in-demand and legit remote nursing jobs for RNs in 2025, including salary ranges and primary duties. Telehealth Nurse Average Pay : $35–$45/hour Best For : RNs with excellent communication and tech skills Telehealth nurses assess patient symptoms, provide medical advice, and determine care needs via phone or video. Common Duties : Triage patient concerns Educate patients on care options Document interactions in EHRs Top Employers : Teladoc Health UnitedHealth Group Amwell Case Management Nurse Average Pay : $65,000–$85,000/year Best For : RNs with hospital discharge or rehab experience Nurse case managers help patients navigate complex medical needs, often after hospital discharge or injury. Responsibilities : Coordinate care plans Communicate with providers and insurers Monitor patient outcomes Where To Apply : Aetna Humana Anthem Blue Cross Utilization Review Nurse (UR Nurse) Average Pay : $70,000–$90,000/year Best For : RNs with attention to detail and clinical knowledge These nurses review patient records to ensure treatments are medically necessary and cost-effective. Tasks Include : Reviewing charts and treatment plans Collaborating with physicians and insurance providers Ensuring compliance with clinical guidelines Hiring Companies : CVS Health Centene Corporation Molina Healthcare Nurse Educator (Online Instructor) Average Pay : $30–$60/hour Best For : RNs with a BSN or MSN and a passion for teaching Teach future nurses in virtual classrooms or help staff stay compliant with healthcare protocols. Key Responsibilities : Develop course materials Conduct online classes or webinars Grade assignments and mentor students Job Boards : Nurse.com HigherEdJobs CareerCartz Nursing Listings Insurance Claims Nurse Average Pay : $65,000–$90,000/year Best For : RNs with claims, billing, or documentation experience These nurses assist insurance companies in reviewing and processing health-related claims. Primary Duties : Review medical records for accuracy Determine necessity of procedures Liaise with claims adjusters Top Employers : Cigna Blue Cross Blue Shield Optum Also Read: Top 1099 Work From Home Jobs in the U.S. for Independent Contractors Remote Clinical Research Nurse Average Pay : $70,000–$100,000/year Best For : RNs with research or trial coordination experience Help coordinate and manage clinical trials from a remote setting, ensuring compliance and safety. Responsibilities : Collect patient data Monitor treatment adherence Prepare documentation for FDA approval Job Boards : ClinicalTrials.gov Medpace Syneos Health Health Coach / Wellness Nurse Average Pay : $25–$45/hour Best For : RNs passionate about lifestyle medicine or preventive care Work with individuals or companies to guide patients in making better health and wellness decisions. Tasks May Include : Creating wellness plans Providing lifestyle education Monitoring progress virtually Hiring Platforms : Omada Health Virgin Pulse Remote Health Coach Jobs via CareerCartz Nurse Recruiter / Talent Acquisition Specialist Average Pay : $30–$50/hour Best For : RNs interested in HR and staffing These nurses help hospitals and clinics hire qualified staff by reviewing resumes, conducting interviews, and vetting credentials. Typical Duties : Source and screen nursing candidates Coordinate interviews and onboarding Understand licensing and credentialing Companies Hiring : AMN Healthcare Cross Country Nurses Aya Healthcare Clinical Documentation Specialist (CDI Nurse) Average Pay : $75,000–$95,000/year Best For : Experienced nurses with charting and coding expertise Ensure that all documentation reflects the care provided and meets billing and legal standards. Responsibilities : Audit medical records Train staff on proper documentation Work with coders and physicians Preferred Employers : Conifer Health nThrive Change Healthcare Triage Nurse (After-Hours Nursing) Average Pay : $32–$48/hour Best For : RNs who prefer evenings/weekends or part-time roles Handle non-emergency health issues via phone or online chat—especially for pediatric and primary care clinics. Common Tasks : Answer patient questions Advise on at-home care or ER needs Document in EHR platforms Who’s Hiring : Children’s Hospital Networks Privia Health DispatchHealth How To Find Legit Work-from-Home Nursing Jobs While demand is rising, so are scams. Follow these tips to find legitimate work-from-home RN jobs : 🔍 Tips To Avoid Scams: Never pay for job access or licenses up front Be wary of vague job offers or unprofessional emails Check company reviews on Glassdoor or Trustpilot Ensure HIPAA compliance and clear job descriptions ✅ Best Platforms To Find Jobs: CareerCartz.com (Nursing Jobs Section) Indeed FlexJobs LinkedIn Remote.co Hospital Career Portals Tools & Tech Skills Needed For Remote Nursing Jobs To thrive in a remote RN career, you’ll need the right tools and tech-savviness. 🖥️ Must-Have Tools: EHR Platforms (Epic, Cerner, Meditech) Video Conferencing (Zoom, Microsoft Teams) Secure Messaging (Slack, TigerConnect) Scheduling Tools (Calendly, Doodle) HIPAA-Compliant Software 💡 Recommended Skills: Strong typing and data entry Telecommunication etiquette Clinical documentation proficiency Remote collaboration How To Transition From Bedside To Remote RN Work Many nurses fear they lack the experience to land a remote job, but transitioning is easier than you think. 🧭 Step-by-Step Guide: Assess your strengths – Education, clinical skills, or case management? Update your resume – Highlight remote-friendly skills Get certified (optional) – CCM, URAC, or Telehealth certifications can help Start part-time or freelance – Gain experience Apply strategically – Use platforms like CareerCartz and tailor each application Conclusion – RN Careers Work From Home With the rise of telemedicine, tech-enabled care, and digital health services, remote nursing jobs for RNs are here to stay. Whether you’re looking to leave the bedside, improve your work-life balance, or pursue a non-traditional nursing path, there are legitimate, high-paying RN jobs you can do from home across the U.S. Stay licensed, keep learning, and explore your options—your ideal nursing job might be just a few clicks away. Also Read: How to Get a Legitimate Test for Working From Home or Skills Test FAQs: RN Careers Work From Home Can registered nurses really work from home? Yes! Many RNs now work remotely in telehealth, case management, education, and administrative roles. Do remote RN jobs pay well? Absolutely. Salaries range from $60K to over $100K depending on experience and specialization. What kind of experience do I need for remote RN jobs? Most require 2–3 years of clinical experience. Specialty experience (ICU, case management) is a plus. Is a compact license required for remote RN jobs? Not always, but it helps when working across multiple states. Telehealth roles may require multi-state licensing. What companies hire remote nurses? Top companies include UnitedHealth Group, Humana, CVS Health, Teladoc, and many startups in digital health. Are remote nursing jobs flexible? Yes, many offer part-time, flexible schedules, or evening shifts—perfect for work-life balance. Can I transition from bedside to remote work easily? Yes. Highlight your clinical expertise and consider certifications in telehealth or case management. What skills are most important for remote nurses? Tech proficiency, communication, time management, and documentation accuracy are crucial. Do remote RN jobs require special training? Some roles may require additional certifications (e.g., CCM, URAC), but many offer on-the-job training. Where can I find the best remote RN jobs? Start at CareerCartz.com, LinkedIn, FlexJobs, and the careers sections of major health companies. Related Posts: Top 1099 Work From Home Jobs in the U.S. for Independent Contractors Work From Home Statutory Employee: What You Need to Know in the U.S. Best Data Annotation Work From Home Jobs Hiring in the U.S. Legit Work From Home Jobs for Stepmoms: Real Opportunities & Flexible Roles in 2025 Top 25 Companies Hiring Remote Jobs in the United States in 2025 High-Paying Work From Home Independent Contractor Jobs You Can Do From Home (U.S. Guide) Step-by-Step: How to Start Your Remote Data Entry Career Today Top 10 Part-Time Remote Jobs You Can Start Today Show more Show less

Greetings from e-care India !!! We are looking for Executive - Credentialing from 1+ Years of Experience Job Essential: Good oral & written communication skills Minimum 1 year of Experience in Credentialing Application Should have Exposure in Multiple states in US & Exposure in Florida will be an advantage Work from office & Day shift resources can apply for the Job . Interested and suitable candidates can share the resume to career@ecareindia.com along with current take home, Expected Take home and Notice period . Regards Aparajitha Rangarajan

Quality Assurance Engineers are responsible for assuring quality of newly developed/enhanced software solutions through manual and automation testing. From requirements analysis and design to implementation, training and support, the Quality Assurance Engineer will work together with a team on diverse projects utilizing knowledge of critical thinking and problem solving. A Quality Assurance Engineer will work tightly with their leadership to understand requirement and project timelines ensuring that software developed adhere to the functional and nonfunctional requirements of the software solution. 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 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 Work with developers, product manager, architects and others to understand functional and nonfunctional requirements, validate and ensure product meets those requirements Develop and enhance the test infrastructure and continuous integration framework used across teams. Determine testing best practices and principals and promote them across the organization. Contribute for developing and executing maintainable automation tests for acceptance, functional, and regression test cases. Integrate project testing with continuous-integration process. Work with fellow team members to diagnose bugs and formulate solutions. Provide functional and technical expertise in bug fixes. Use test automation techniques (data driven, pairwise, mocking, test hooks) that fit the problem space. Understand designing and coding for testability to produce quality code with the lowest cost. Participate in internal and external technical reviews, as required Skills Required Excellent time management, resource organization and priority establishment skills, and ability to multi-task in a fast-paced environment Ability to work independently and as part of a team 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 Should have understanding SOLID design principals Strong Object-Oriented design and implementation skills Ability to develop test automation framework using in C# /Java/TypeScript, Selenium, WDIO, SQL and BDD Strong knowledge of enterprise computing software, including system management standards and solutions 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 5 years’ experience with software testing post BE/B.Tech, ME/M.Tech or MCA Must have experience with manual and automation testing of enterprise applications with web user interface, Mobile and web services Must have experience with C#/.NET or Java Must have experience with SQL query writing Must have experience with Selenium web driver Passionate about technology and application development 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

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 Summary We are seeking a dedicated and detail oriented Team Leader Operations with 4 to 5 years of experience in Accounts Receivable The ideal candidate will have a strong understanding of revenue cycle management and be able to effectively manage a team in a hybrid work model This role requires night shift availability and does not require travel Responsibilities Manage and oversee the daily operations of the accounts receivable team Ensure timely and accurate processing of accounts receivable transactions Monitor and analyze accounts receivable data to identify trends and areas for improvement Implement strategies to reduce outstanding receivables and improve cash flow Collaborate with other departments to resolve billing and payment issues Provide regular reports on accounts receivable performance to senior management Develop and maintain policies and procedures for accounts receivable processes Train and mentor team members to ensure high performance and professional growth Utilize denial processing and provider credentialing knowledge to enhance operational efficiency Ensure compliance with company policies and regulatory requirements Address and resolve any escalated issues related to accounts receivable Foster a positive and productive work environment within the team Utilize revenue cycle management expertise to optimize financial outcomes Qualifications Possess a strong background in accounts receivable with 1 to 5 years of relevant experience Demonstrate knowledge of denial processing and provider credentialing Have experience in revenue cycle management and accounts receivables Exhibit excellent analytical and problem solving skills Show proficiency in using accounts receivable software and tools Display strong communication and interpersonal skills Be able to work effectively in a hybrid work model and night shift Demonstrate the ability to lead and motivate a team Have a keen eye for detail and accuracy Show a commitment to continuous improvement and professional development Be adaptable and able to handle multiple priorities Exhibit strong organizational and time management skills Maintain a high level of integrity and confidentiality

Experience: 1-2 years in AR calling (US healthcare) Exp in denial management and handling AR calls Exp with healthcare billing software Ensure accurate & timely follow up where required. Required Candidate profile Immediate Joiners are preferred Should have worked on appeals, AR Follow-up, refiling & denial management Job Location: Mysore, Bangalore Chennai Email: manijob7@gmail.com Call or Whatsapp 9989051577

Job Description - Quality Analyst Minimum 5 year of experience in AR & 1 year experience in QA On paper Quality Analyst Must worked in physician billing -CMC1500 Work from Office Required Candidate profile Immediate - 15 days preferable,US Shift Transportation available (Within 20 km) Should have knowledge in Denials Health insurance Email: manijob7@gmail.com Call or Whatsapp 9989051577

We are pleased to inform you that we are organizing a Mega Walk-In Drive at our Bangalore office on 28th May 2025 (Saturday), 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

Job Description Greetings from Augment Technology Solutions! We have urgent requirement for AR callers experienced in denial management- Male only. EXPERIENCE:- Min of 1+ yrs experience in US Medical Billing. Should have good Verbal and Written communication skills. Immediate joiners are preferred. Candidates with AR Calling experience will be added advantage. Candidates should have strong knowledge in Denial management. Freshers can also apply Time: Please call HR to schedule interview Walk-In Between : Monday to Friday: 10:00 a.m till 5:00 p.m for first level interview for freshers. If experienced call to HR to schedule interview. HR Phone number: Keerthana - 7305991117 You will have 3 interview levels, spot offer will be issued. Office location: Augment Technology Solutions! 2nd Floor, MM Tower, 426/469, Madras Thiruvallur High Rd, Manthoppu Nagar, Ambattur, OT, Chennai, Tamil Nadu 600053 Role: Technical Support - Voice / Blended Industry Type: Medical Services / Hospital Department: Customer Success, Service & Operations Employment Type: Full Time, Permanent Role Category: Voice / Blended

Senior 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. Senior Software Engineers are often given more complex tasks and aid with research and design on difficult or time sensitive projects or issues. They are also tasked with technical leading and mentoring Development Engineers. A Senior Software Engineer will work tightly with their leadership in understanding requirement and project timelines. Working with Software 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 As Senior Developer, accountable for right technical solution, quality of features developed and on time delivery 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 Mentor software engineers on design principles, engineering practices and be resourceful 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 Excellent time management, resource organization and priority establishment skills, and ability to multi-task in a fast-paced environment Experienced in technical leadership Ability to work independently and as part of a team Robust understanding of OOPS and design patterns 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 Expert in technical practices like clean code, unit testing, design and be SME in those areas Strong knowledge of enterprise computing software, including system management standards and solutions Strong Object-Oriented design and implementation skills Robust understanding of design and architectural patterns Understanding of NuGet package management including creation, deployment and version management Strong understanding of relational database design concepts 10+ years’ experience with software development post BE/B.Tech, ME/M.Tech or MCA Experienced in design and development of software in PHP, symfony, Doctrine, HTML, Java Script, CSS, Webservices and SQL/PLSQL Experienced in design and developing enterprise level software solutions using LAMP Stack on AWS Experienced in design and development of hybrid mobile applications using Angular, IONIC Good understanding and experienced with CI/CD using Jenkins and ADO Pipelines Passionate about technology and application development Should have worked with Agile Scrum 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. https://www.symplr.com/ Show more Show less

This role supports Verisys by enhancing and maintaining core operational applications that deliver elite customer credentialing, monitoring, and data services. Working alongside team members, stakeholders and customers, you will solve and implement solutions to drive world-class SAAS applications and services that delight our internal and external customers. Duties/Responsibilities: Write quality code that is robust, testable, and follows software engineering best practices. Design applications that provide appropriate monitoring and logging and are resilient to local and neighboring service interruptions. Perform detailed code reviews and provide positive critiques and feedback. Work closely with stakeholders and team members to set goals, define tasks, and deliver incremental functionality following Scrum/Agile methodologies. Contribute to team growth by providing positive feedback and collaborating with other engineers and stakeholders. Develop highly performant user interfaces and APIs to deliver data services to other internal teams or external customers. Performs other related duties as assigned. Required Skills/Abilities: Ability to develop user interfaces and the data services behind the interface. Ability to prioritize work and complete tasks with little to no supervision. Excellent communication skills, both verbal and written. Experience building software and pipelines in a cloud environment. Experience working with Scrum/Agile/Kanban methodologies. Strong organizational skills and attention to detail. Knowledge of a variety of agile methodologies. Education/Experience: Required : 6+ years of hands-on software development experience. Proficient in Microsoft technologies (.Net, ASP.net, entity framework, C#, Web API etc.) and other object-oriented programming languages. Experience working on UI technologies like React. Preferred : Degree in Computer Science, Computer Engineering, or related technical discipline. Knowledge of professional software engineering practices and best practices for the full software development life cycle, including coding standards, code reviews, source control management, build processes, testing, and operations. Experience with multiple database technologies such as SQLServer, Postgres, Redis, etc. Experience with microservices. Experience in AWS, Docker, CI/CD workflows, Azure Devops. Test Driven Development (TDD) experience. Healthcare or Pharmaceutical experience. Show more Show less

Position Overview We are seeking a detail-oriented and highly organized Credentialing Specialist to join our team. This role is pivotal in ensuring the accurate and timely verification of healthcare providers' qualifications, licenses, and certifications. The Credentialing Specialist will support the recruitment process by managing the credentialing lifecycle and maintaining up-to-date records in credentialing databases. Work Location: DSL Abacus IT Park, Uppal, Hyderabad Salary range: As per market standards + Incentives Official website: https://www.protouchstaffing.com/ Key Responsibilities Credential Verification and Validation: Verify and validate the professional qualifications, licenses, certifications, education, work history etc., Ensure primary source verification of credentials in accordance with established regulatory requirements (e.g. state licensing boards, Board Certification organizations). Regulatory Compliance: Maintain up-to-date knowledge of federal, state, and accreditation standards (e.g., Joint Commission, NCQA, CMS) to ensure full compliance during the credentialing process. Manage re-credentialing processes to ensure healthcare providers maintain ongoing compliance. Database and System Management: Oversee the management and maintenance of credentialing databases. Track, input, and update all credentialing documentation, ensuring data accuracy and integrity within systems. Discrepancy Resolution: Proactively communicate with facilities or Hospitals, and regulatory agencies to resolve discrepancies, missing documents, or inaccuracies in credentials and applications. Perform follow-ups to ensure the timely resolution of any discrepancies or incomplete credentialing files. Onboarding and Documentation Management: Facilitate the onboarding process by ensuring all credentialing documentation (e.g., licensure, certification) is complete, accurate, and up-to-date for healthcare professionals. Prepare and submit provider applications and facility participation, ensuring all necessary documentation is submitted according to deadlines. Reporting and Audits: Generate and review credentialing reports to track progress, compliance, and any pending issues or requirements. Participate in internal and external audits, assisting with documentation requests and audit preparations. Communication and Collaboration: Collaborate closely with recruiters, healthcare facilities, and provider relations teams to streamline the credentialing process and ensure seamless provider onboarding. Serve as a point of contact for healthcare facilities, and insurance payers regarding credentialing-related inquiries and concerns. Continuous Improvement: Recommend and implement process improvements for credentialing operations, enhancing efficiency and compliance. Stay current on trends, best practices, and changes in credentialing regulations to continuously improve the quality of services provided. Qualifications Bachelor's degree in Healthcare Administration, Business, or related field preferred. Freshers are eligible to apply. Excellent attention to detail, organizational, and time management skills. Strong written and verbal communication skills, with the ability to interact professionally with healthcare providers and regulatory bodies. Work Environment Full-time position - Work from office only This job description outlines the essential functions and qualifications for a Credentialing Specialist in the US healthcare recruitment industry, focusing on maintaining regulatory compliance and efficient provider onboarding processes. Welcome to Protouch (www.protouchstaffing.com) - Your Pathway to Perfect Staffing Protouch Staffing is a seasoned and success-driven staffing firm with more than 32 years of industry experience. Our mission is simple and our standards are high: we're working to discover and deliver top-notch talent in the healthcare industry. We believe it's our job to make it easy for healthcare professionals (clinical and non-clinical) to find new career opportunities and get back to what they love: making positive impacts on patients. Founded by nurses in 1989, our 'pro touch' means personalized attention. We aim to be a resource to both job seekers and healthcare organizations. Let us exceed your expectations! Show more Show less

Job Title: US Healthcare Trainees– Healthcare Operations(RCM and Credentialing process) Location: Gurugram, India Company: Neolytix Experience Required: Freshers (0–1 year) Employment Type: Full-time (Onsite role, 5-day work week) Job Description: Neolytix, a fast-growing healthcare services company, is looking for fresh graduates to join us as RCM Trainees – Credentialing and Billing Operations . This is an excellent opportunity for individuals seeking to build a career in Revenue Cycle Management (RCM) , medical billing, and healthcare operations. If you are looking for a structured and growth-driven career in a dynamic environment, this role is perfect for you. What You Will Do: Training and Development: Participate in structured onboarding and training on US healthcare, RCM processes, and medical billing Live Project Exposure: Work with experienced teams on operational tasks like claims processing, payment posting, and denial management Specialization and Growth: Transition into an RCM specialist role after 3-6 months, with opportunities to specialize, lead projects, and manage teams Collaboration: Engage in a collaborative environment where you’ll support teams in meeting client SLAs and compliance goals Continuous Learning: Stay updated with changing US healthcare regulations and contribute to operational excellence Why Join Neolytix? Comprehensive Training: Hands-on training in RCM, US healthcare systems, and medical billing Career Growth: Opportunities to specialize, lead, and mentor within a growing, fast-paced environment Team Culture: Work closely with a collaborative team to learn and grow Work Environment: Enjoy a professional culture, with mentoring to drive career development Key Responsibilities: Gain in-depth training in RCM processes, including credentialing, insurance billing, CPT coding, and healthcare workflows Support teams in live projects related to claims processing, payment posting, and denial management Assist in monitoring performance metrics and meeting client deliverables Adapt to evolving US healthcare rules, ensuring compliance and operational efficiency Grow into specialized roles or take on leadership responsibilities as you progress in your career Qualifications: Education: Recent graduates with preferredbackground in Science or Commerce(preferred degrees: B.Sc, BCA, BBA, B.Com, or similar) Academic Eligibility: Minimum 70% aggregate in 12th grade (CBSE/ICSE or equivalent) Skills: Strong communication and comprehension skills Familiar withMicrosoft Excel and Word Schooling from Delhi-NCR or other Tier-1/Cosmopolitan cities preferred Strong analytical abilities and attention to detail Note : Only candidates meeting the above eligibility criteria will be considered. Salary: Up to ₹3 LPA (based on performance during training and assessments). How to Apply: If you're ready to start your career in healthcare operations, gain industry-leading knowledge, and grow with a forward-thinking team, apply now! Application Instructions: Click Apply Now to submit your resume and application Powered by JazzHR fhU29EQHJa Show more Show less

- Must have experience in credentialing and should be an AR analyst to fix the Denia - Gurgaon Location, Both Side Cab, Only Work From Office, "NO Work from Home" - Net Salary Upto Rs.50,000 - What's app CV @ 9560158261 Perks and benefits Incentive

Experience: 1-4years in AR calling (US healthcare) Exp in denial management and handling AR calls Exp with healthcare billing software Ensure accurate & timely follow up where required. Required Candidate profile Immediate Joiners are preferred Should have worked on appeals, AR Follow-up, refiling & denial management Job Location: Noida,Bangalore Chennai Email: manijob7@gmail.com Call or Whatsapp 9989051577

Job Summary We are seeking a Process Specialist with 5 to 7 years of experience in HealthCare Products. The ideal candidate will have expertise in Prov Privileges excl Hospital Demo Changes Credentialing and Re-credentialing. This hybrid role requires working night shifts and does not involve travel. The candidate will play a crucial role in ensuring the efficiency and accuracy of healthcare processes. Responsibilities Lead the implementation of healthcare product processes to ensure compliance with industry standards. Oversee the management of provider privileges excluding hospital settings. Provide expertise in handling demographic changes within healthcare systems. Ensure accurate and timely credentialing and re-credentialing of healthcare providers. Collaborate with cross-functional teams to streamline healthcare operations. Monitor and evaluate process performance to identify areas for improvement. Develop and maintain documentation for healthcare processes and procedures. Train and mentor team members on best practices and process improvements. Conduct regular audits to ensure adherence to regulatory requirements. Utilize data analytics to drive decision-making and enhance process efficiency. Communicate effectively with stakeholders to address process-related issues. Implement process changes to improve patient care and operational efficiency. Support the development and execution of strategic initiatives in healthcare operations. Qualifications Possess a strong background in healthcare products and processes. Demonstrate expertise in provider privileges excluding hospital settings. Have experience in managing demographic changes within healthcare systems. Show proficiency in credentialing and re-credentialing of healthcare providers. Exhibit strong analytical and problem-solving skills. Display excellent communication and collaboration abilities. Certifications Required Certified Provider Credentialing Specialist (CPCS)

As the Engineering Manager , you will have technical ownership of critical enterprise software solution. You will build the team to deliver the vision. Responsibilities include direct management of a team of 8-10 engineers, process and quality of service improvements, strategic planning, and management of resources across teams. Successful candidates will be strong leaders who can prioritize well, communicate clearly, and have a consistent track record of delivery. You should have great communication skills, a working knowledge of different engineering disciplines and how they relate to one another, and an aptitude for managing risk. Duties & Responsibilities Work closely with Engineering Team, Product Team and architect to develop the best technical designs, architectures and implementations. Actively contribute to monthly, quarterly and yearly strategy and roadmaps for the team based on project priorities. Excellent written and verbal communication skills with the ability to present complex technical information in a clear and concise manner to a variety of audiences. Work with Product and Program Managers to develop and evolve the vision and strategy for the team and Deliver software solutions to customers. Use Agile principles to run the development lifecycle for team’s applications and services and manage, execute and communicate as per delivery commitments. Hire, manage, mentor and grow a high-performance team of Software Engineers. Provides coaching, feedback, developmental opportunities, etc. to directs Skills Required BE, ME/MTech. Preferably in Computer Science. 10+ years experience in IT industry. People management experience, managing engineering teams. Experience in programming languages like C#/.Net, Angular and cloud technologies. Deep hands-on technical expertise in enterprise software solution design. Ability to handle multiple competing priorities in a fast-paced environment. A deep understanding of software development in a team, and a proven track record of shipping software on time Demonstrated passion for people leadership, management and mentoring with high sense of ownership, urgency, and drive. Preferred Qualifications Exposure Cloud technologies like Azure and/or AWS Knowledge of Healthcare domain Strong problem-solving skills along with good judgment and negotiation skills and ability to influence. 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. https://www.symplr.com/ Show more Show less

Job Summary We are seeking a Process Specialist with 5 to 7 years of experience in HealthCare Products. The ideal candidate will have expertise in Prov Privileges excl Hospital Demo Changes Credentialing and Re-credentialing. This hybrid role requires working night shifts and does not involve travel. The candidate will play a crucial role in ensuring the efficiency and accuracy of healthcare processes. Responsibilities Lead the implementation of healthcare product processes to ensure compliance with industry standards. Oversee the management of provider privileges excluding hospital settings. Provide expertise in handling demographic changes within healthcare systems. Ensure accurate and timely credentialing and re-credentialing of healthcare providers. Collaborate with cross-functional teams to streamline healthcare operations. Monitor and evaluate process performance to identify areas for improvement. Develop and maintain documentation for healthcare processes and procedures. Train and mentor team members on best practices and process improvements. Conduct regular audits to ensure adherence to regulatory requirements. Utilize data analytics to drive decision-making and enhance process efficiency. Communicate effectively with stakeholders to address process-related issues. Implement process changes to improve patient care and operational efficiency. Support the development and execution of strategic initiatives in healthcare operations. Qualifications Possess a strong background in healthcare products and processes. Demonstrate expertise in provider privileges excluding hospital settings. Have experience in managing demographic changes within healthcare systems. Show proficiency in credentialing and re-credentialing of healthcare providers. Exhibit strong analytical and problem-solving skills. Display excellent communication and collaboration abilities. Certifications Required Certified Provider Credentialing Specialist (CPCS) Show more Show less

Medical Services/Hospital Full-Time Job ID: DGC00450 Chennai, Tamil Nadu 1-6 Yrs ₹1.5 - ₹8.5 Yearly Job description Preferred candidate profile We are looking for a Cardiac Nurse, also known as a Cardiovascular Nurse, to provides specialized care to patients with heart conditions . Their responsibilities include monitoring vital signs, administering medications, assisting with procedures, educating patients and families about cardiac health, and responding to cardiac emergencies. They may work in various settings, including hospitals, cardiac care units (CCUs), and cath labs. Skills and Qualifications: Education: Typically requires an associate's or bachelor's degree in nursing. Certification: Many cardiac nurses pursue specialized certifications, such as the American Nurses Credentialing Center's certification in Cardiovascular Nursing. Knowledge: Strong knowledge of cardiovascular anatomy, physiology, and disease processes is essential. Skills: Skills in critical thinking, problem-solving, communication, and interpersonal relationships are crucial. Experience: Experience in a critical care setting, such as a CCU, is often preferred.