Job Description

Should have working experience in US Healthcare -Credentialing Process-Payer and Provider Processes. Must have knowledge of Delegation Process. Ensure credentialing processes are following professional standards, bylaws, state and federal regulatory requirements. Verifying primary source data, such as provider education, board certifications, licensure, and other eligibilities /documents. Work on experience in All modules of CAQH. Overall, should be expertise with CAQH. Ensuring timely credentialing and re-credentialing of network providers and working with Internal/External Team to ensure credentialing files completed within timeframe and compliance.