1325 Credentialing Jobs - Page 4

Location: Dattagalli, 3rd Stage Mysore Shift: Night (U.S. Time Zone) Experience: 1–3 years in U.S. healthcare credentialing Role Description Looking for a detail-oriented Credentialing Specialist to handle provider enrollment and re-credentialing with Medicare, Medicaid, and commercial payers. Responsibilities include managing CAQH, NPPES, and payer portal updates, tracking application status, maintaining records, and coordinating with providers and payers for timely approvals. Requirements: 1–3 years of experience in provider credentialing. Knowledge of CAQH, PECOS, Availity, and payer portals. Strong communication and follow-up skills. Proficient in MS Office. Must be willing to work night...

About Certify At Certify, we're building the infrastructure that powers the next generation of provider data products, making healthcare more efficient, accessible, and innovative. Our platform serves as the ultimate source of truth for provider data, offering unparalleled ease and trust while making data easily accessible and actionable across the 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 deliver unmatched visibility and automation throughout the provid...

Job Description Key Responsibilities: Supervise daily AR operations for assigned clients/projects. Monitor AR aging buckets and ensure timely follow-up on outstanding claims. Drive resolution of denials (Authorization, Eligibility, Credentialing, Coding, etc.). Ensure compliance with TAT, productivity, and quality SLAs. Provide coaching, mentoring, and performance feedback to AR team members. Coordinate with internal teams (Billing, Coding, Credentialing) to resolve issues. Generate AR reports, highlight trends, and suggest process improvements. Handle escalations and act as the first point of contact for clients. Track KPIs such as AR days, aging %, denial rate, and collection efficiency. Q...

Job Description Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has...

The Learning & Development Manager will lead the development of commercial capabilities to support business excellence. The L&D Manager will work in close partnership with the Cluster L&D Lead to support and implement learning and development initiatives across all AP markets. Responsibilities Design, deliver, and evaluate learning programs that build functional competencies and address performance gaps, aligned with commercial strategies. Plan, develop, and implement L&D initiatives to enhance sales and marketing effectiveness. Coordinate and manage training activities and services for commercial teams. Support and coach individuals in identifying strengths, development needs, and career gr...

Job Summary: We are seeking a Senior Mentor specializing in various fields, including Doctor, Lawyer, and Semiconductor, to provide guidance and expertise. This full-time position in Chennai offers a unique opportunity to shape the future of professionals across diverse specializations. The role involves sharing knowledge, providing mentorship, and contributing to the development of future leaders. Key Responsibilities: Provide expert mentorship and guidance to professionals in the fields of medicine, law, and semiconductors. Share industry insights and best practices to enhance the professional development of mentees. Offer career advice and support to help mentees achieve their professiona...

Excellent communication skills. Should have worked as a Credentialing Analyst, medical billing service providers. Good Knowledge in Provider credentialing. Good knowledge in clearing house setup. Electronic Data Interchange setup (EDI). Electronic Remittance Advice Setup (ERA). Establish Insurance Portals (EFT). Experience in Insurance calling. Good knowledge in filling insurance enrollment applications. Good experience in CAQH, PECOS application. Experience in Medicare, Medicaid, Commercial insurance enrollment. Positive attitude to solve problems. Knowledge of generating aging report. Preferred immediate joiners. Flexible with shift timings.

Role & responsibilities Enrolls providers (individually or in groups) with Medicare, Medicaid, and all major private insurance payers. Should have exposure in handling PECOS and NPPES systems - Strong knowledge in CAQH application and Facilitate provider re-attestations of CAQH data as required by CAQH. Verifies completeness and accuracy of application documents, coordinates with onshore team and payer support to obtain all necessary information. Promptly submits applications to ensure maximum reimbursement for all providers. Performs electronic funds transfer (EFT) and electronic remittance advice (ERA) enrollment for all providers, for all applicable payers. Compiles and maintains a list o...

Verify provider credentials, licenses, certifications, education, and work history. Ensure compliance with NCQA, JCAHO, CMS, and other applicable standards. Communicate with providers and internal teams regarding credentialing statuses and needs.

Role: AR Caller (Pb/Hb) Experience: Minimum 1 year Strong experience in US healthcare billing (Pb & Hb) Interview Mode: Virtual Required Candidate profile Process: Physician Billing or Hospital Billing -Denial Management Voice Priority: quality profiles / immediate joiners Work Mode: Work From Office Email: manijob7@gmail.com Call or WhatsAp 9989051577

Mega Walk-In Drive for Experienced Credentialing Specialists on 25 Oct'2025 @EqualizeRCM ,Coimbatore Roles and Responsibilities 1 year 4 years of Relevant Experience (Provider Credentialing) Ability to check providers current enrollment status, obtain Procedure to get a provider enrolled and complete Applications/Request as required by the insurance companies. Should have experience in completing Applications/Request/CAQH with required accuracy. Should have experience in Calling/Sending Emails/Sending Fax to payor for Credentialing Status of a Provider. Meet compliance requirements like HIPAA etc. Meet QMS and ISMS requirements. Meet productivity and Quality Standards. Experience in CAQH, Ap...

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

A Credentialing Coordinator manages and oversees the credentialing process for physicians and other healthcare providers. This ensures that all providers meet regulatory, legal, and organizational requirements to practice medicine in a hospital, clinic, or health system. Key Responsibilities Application Management Collect and process physician applications for medical staff privileges. Verify the accuracy and completeness of submitted documents. Primary Source Verification Check education, training, residency, board certifications, state licenses, DEA registrations, and work history directly with issuing institutions. Ensure no gaps or discrepancies in physician history. Regulatory Complianc...

Role Overview: As an L4 Chapter Leader in the Credentialing and Contracting Team, you will be responsible for overseeing the end-to-end credentialing process, ensuring provider applications are accurately completed, tracked, and submitted in a timely manner. You will lead a team focused on maintaining compliance, improving documentation quality, and ensuring operational excellence. Responsibilities: Opportunity Identification Pre-Application Analysis Application Filling Application Compilation and Submission Application Tracking and Follow-up Provider & Document Escalation Skills: Thorough Documentation Detail-oriented Proactive Communication Continuous Improvement Compliance-focused Qualifi...

Spintly is a fast-growing startup reimagining access control and smart building management. With our wireless, cloud-based platform, we eliminate complex wiring and outdated keycards, replacing them with a seamless smartphone-first experience. Our open APIs and integrations enable all kinds of businesses - co-working spaces, enterprises, residential complexes, industries, healthcare facilities - to manage access, security, and people flow effortlessly. Backed by cutting-edge IoT and mesh technology, Spintly delivers scalable, cost-efficient solutions that are transforming how the world thinks about physical security. We are seeking a dynamic and hands-on Training & Development Manager to lea...

This job is with Organon, an inclusive employer and a member of myGwork – the largest global platform for the LGBTQ+ business community. Please do not contact the recruiter directly. Job Description The Position As a member of the team in Business Technology, the successful candidate will be part of the Network Service Delivery and Operations team ensuring the operation of our Company's Global Network. These services allow our Company to communicate globally and collaborate worldwide with partners and customers. Responsibilities Work to support the continuity, stability and security of Organon's network. Assist with network requests coming from other teams. Troubleshoot network related issue...

Role Summary- The Operations Manager will lead a team to meet the inventory services Operations service goals while maintaining a high level of customer satisfaction. The manager will interact with internal stakeholders and GHX North America leadership to provide operational oversite and ensure we meet our delivery targets. Required Skills- Applicable experience in the healthcare, life sciences, or medical technology industry Good Knowledge of SQL, Access, and Advanced Excel Experience of working with large datasets and databases in Managed Data Services or Master Data Management, Data reconciliation, enrichment, quality and governance Excellent communication skills, including English; verba...

Spintly is a fast-growing startup reimagining access control and smart building management. With our wireless, cloud-based platform, we eliminate complex wiring and outdated keycards, replacing them with a seamless smartphone-first experience. Our open APIs and integrations enable all kinds of businesses - co-working spaces, enterprises, residential complexes, industries, healthcare facilities - to manage access, security, and people flow effortlessly. Backed by cutting-edge IoT and mesh technology, Spintly delivers scalable, cost-efficient solutions that are transforming how the world thinks about physical security. We are seeking a dynamic and hands-on Training & Development Manager to lea...

Role Overview: You will be a full-time on-site Medical Equipment Service Manager in Kolkata, responsible for overseeing the maintenance and repair of medical equipment. Your primary tasks will include ensuring all equipment is functioning properly, managing service contracts, coordinating with medical staff, and ensuring compliance with safety and accreditation standards. Additionally, you will interact with customers to resolve service issues and provide exceptional customer service. Key Responsibilities: - Oversee maintenance and repair of medical equipment - Ensure all equipment meets regulatory standards - Manage service contracts and coordinate with medical staff - Ensure compliance wit...

💼 We’re Hiring: Non-IT Recruiter (US Staffing), Chennai OnSite (Immediate Joiners Apply) 🚩 Company: Avacend Solutions Private Limited 📍 Location: TICEL Bio Park, Taramani, Chennai 🏢 Work Mode: In-Office Only 🕖 Shift Timing: US / Night Shift (7:00 PM – 4:00 AM IST) 👥 Open Positions: 5 🔗 Learn more about us: www.avacendsolutions.com 🌟 What We’re Looking For ✅ 3-6 years of experience in US IT Recruitment ✅ Any Graduate Degree ✅ Strong exposure to US IT Staffing lifecycle ✅ Excellent communication & negotiation skills ✅ Familiarity with US compliance, credentialing, and documentation ✅ Ability to work in a fast-paced, performance-driven environment 🎯 What You’ll Do 🔹 Source candidates through jo...

Company Description TriumpHealth is a leading Revenue Cycle Management (RCM) partner, empowering healthcare organizations to achieve financial success and maintain regulatory compliance. We work with a diverse range of healthcare providers, medical and dental practices, hospital systems, FQHCs, DME suppliers, and home health agencies. Our services include provider credentialing, ancillary and facility credentialing, payer contract negotiations, MIPS consulting, medical billing and coding, and practice start-up. Serving over 3000 healthcare providers nationwide, TriumpHealth delivers customized solutions that streamline operations and improve patient outcomes. Role Description This is a full-...

Role Overview As an L4 Chapter Leader in the Credentialing and Contracting Team, you will be responsible for overseeing the end-to-end credentialing process, ensuring provider applications are accurately completed, tracked, and submitted in a timely manner. You will lead a team focused on maintaining compliance, improving documentation quality, and ensuring operational excellence. Responsibilities Opportunity Identification Pre-Application Analysis Application Filling Application Compilation and Submission Application Tracking and Follow-up Provider & Document Escalation Skills Thorough Documentation Detail-oriented Proactive Communication Continuous Improvement Compliance-focused Qualificat...

The Position As a member of the team in Business Technology, the successful candidate will be part of the Network Service Delivery and Operations team ensuring the operation of our Company's Global Network. These services allow our Company to communicate globally and collaborate worldwide with partners and customers. Responsibilities Work to support the continuity, stability and security of Organon’s network. Assist with network requests coming from other teams. Troubleshoot network related issues. Cooperate with Network Engineering and Architecture team on solving complex incidents. Required Experience and Skills This role requires a skilled individual with at least 5 years of experience in...

Role & responsibilities Key Responsibilities:Prepare, review, and submit credentialing and re-credentialing applications for healthcare providers.Coordinate with insurance companies, medical groups, and clients to ensure timely enrollment.Maintain credentialing databases and track the status of applications.Communicate with clients and providers to resolve discrepancies or missing documentation.Ensure compliance with regulatory guidelines and organizational standards Preferred candidate profile

Company Description : Elico Healthcare Services Ltd. is a trusted and renowned healthcare partner, offering holistic and tailor-made RCM solutions to hospitals, physician groups, EMS providers, and credentialing and contracting agencies. Promoted by Elico Ltd., the company has a proven track record of business excellence and pioneering innovations in laboratory analytical instruments. With strategic business units in Hyderabad, Chennai, and Mysore, Elico Healthcare Services boasts a dedicated team of over 850 professionals focused on delivering value-based strategies and integrated analytics to enhance patient care and financial performance. Serving clients since 1999, the company is committ...