9 Credentialing Software Jobs

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10.0 - 14.0 years

0 Lacs

punjab

On-site

As an Assistant Manager Credentialing, you will report directly to the Director of Credentialing & Contracting. Your responsibilities will include: - Providing regular updates on the team's performance, key metrics, achievements, and areas needing improvement - Keeping the director informed of progress, milestones, and potential roadblocks on specific projects - Reporting on the team's progress towards set goals and objectives, aligning them with the overall organizational strategy - Swift reporting of challenges or issues faced by the team such as resource constraints, conflicts, or technical problems - Making recommendations to the director on performance improvement, process optimization,...

Posted 13 hours ago

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3.0 - 7.0 years

0 Lacs

pune, maharashtra

On-site

As a Quality - Credentialing, your role involves ensuring the accuracy, completeness, and compliance of credentialing processes for US healthcare professionals. You will audit credentialing files and documentation, validate provider credentials, identify discrepancies, and provide feedback to the credentialing team. Additionally, you will maintain quality tracking logs, collaborate with teams to develop SOPs, participate in audits, and stay updated on industry standards. Key Responsibilities: - Audit credentialing files and documentation for accuracy and completeness. - Validate provider credentials such as licenses, certifications, and work history. - Identify discrepancies and provide acti...

Posted 13 hours ago

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4.0 - 6.0 years

0 Lacs

vadodara, gujarat, india

On-site

Overview We are seeking a Credentialing Manager (India) to oversee the day-to-day operations of the credentialing team supporting our Revenue Cycle Management Services (RCMS) customers. This role will be responsible for managing credentialing processes, ensuring compliance with payer and regulatory requirements, optimizing tools and systems to ensure efficiency and a positive customer experience, and driving operational excellence. The Credentialing Manager will collaborate closely with U.S. stakeholders, the India Director of Operations, and cross-functional teams to ensure credentialing operations meet customer expectations and contribute to growth and retention. Key Responsibilities Manag...

Posted 3 weeks ago

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1.0 - 5.0 years

0 Lacs

chennai, tamil nadu

On-site

The role involves managing the full-cycle credentialing and re-credentialing process for healthcare providers. This includes verifying and maintaining provider documentation, licenses, certifications, and affiliations. Coordination with insurance companies, hospitals, and healthcare organizations for provider enrollment is crucial. Compliance with NCQA, CMS, and other regulatory requirements must be ensured. It is essential to maintain accurate and up-to-date records in credentialing databases. Effective communication with providers regarding application status, missing information, or required updates is necessary. Additionally, supporting audits, reporting, and quality improvement initiati...

Posted 1 month ago

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1.0 - 5.0 years

0 Lacs

chennai, tamil nadu

On-site

As a Credentialing professional in Chennai, you will be responsible for collecting, reviewing, and verifying providers" education, training, licensure, certifications, and work history. Your role will involve ensuring compliance with state, federal, and organizational regulations. Additionally, you will be completing and submitting applications for provider enrollment with insurance networks, Medicare, Medicaid, and hospital privileges. It will be your duty to track application status, follow up on pending approvals, and maintain up-to-date provider information in credentialing databases and systems. You will play a crucial role in tracking expiration dates for licenses and certifications to...

Posted 1 month ago

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10.0 - 14.0 years

0 Lacs

punjab

On-site

As an Assistant Manager Credentialing, you will report to the Director of Credentialing & Contracting. Your responsibilities include providing regular updates on the team's performance, project progress, milestones, and challenges faced. You will ensure the team aligns with set goals and objectives, addressing any issues promptly and making recommendations for improvement. Your role involves completing, coordinating, and auditing provider applications and credentialing packets. It is essential to maintain up-to-date documentation and ensure compliance with recredentialing and re-enrollment processes to avoid coverage gaps or billing disruptions. You will oversee a team of Team Leads, Credent...

Posted 2 months ago

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6.0 - 10.0 years

0 Lacs

noida, uttar pradesh

On-site

You will be responsible for managing end-to-end provider enrollment and re-credentialing processes with insurance networks, hospitals, and healthcare facilities. This includes reviewing provider documentation for accuracy, completeness, and compliance before submission and ensuring timely completion of credentialing tasks. Additionally, you will train, mentor, and evaluate team members to maintain quality standards and achieve productivity goals. Your role will also involve generating and analyzing reports on credentialing status, performance metrics, and compliance indicators. Collaborating with internal departments, clients, and third-party entities to optimize credentialing workflows will...

Posted 2 months ago

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2.0 - 6.0 years

0 Lacs

ahmedabad, gujarat

On-site

As a Credentialing Analyst at Medusind, you will play a crucial role in managing and maintaining credentialing files for healthcare providers to ensure compliance with regulatory standards and guidelines. Your responsibilities will include data entry, verification of credentials, communication with healthcare organizations and insurance companies, and maintaining accurate records. To excel in this role, you should have experience in credentialing, data entry, and verification processes. Strong organizational skills and attention to detail are essential for successfully managing the credentialing files. Your excellent written and verbal communication skills will be valuable in liaising with p...

Posted 3 months ago

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3.0 - 7.0 years

0 Lacs

punjab

On-site

As a Credentialing Specialist at our company, your primary responsibility will be to manage all provider credentialing activities efficiently. This includes collecting, verifying, and maintaining essential provider information such as licenses, certifications, and work history. You will also be responsible for submitting credentialing applications to insurance companies and credentialing bodies. In addition to provider credentialing, you will be tasked with tracking and completing re-credentialing and re-enrollment processes before expiration dates. Data management is a crucial aspect of this role, where you will update credentialing databases and ensure that all documents are current and ac...

Posted 3 months ago

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