14 Credentialing Software Jobs

Company Description Dental Outsource is the dedicated back-office support for Altius Healthcare, a leading dental healthcare provider headquartered in Dallas, USA, with over 25 clinics across the country. Located in Mohali, India, Dental Outsource specializes in delivering high-quality operational and administrative support for dental practices. We are committed to excellence in streamlining operations to allow dental practices to focus on patient care. Role Description This full-time on-site role as a Credentialing Coordinator is based in Chandigarh, India. The Credentialing Coordinator will handle day-to-day credentialing tasks, including verifying professional qualifications and ensuring ...

As a Credentialing Specialist at our company, you will play a crucial role in managing time-sensitive credentialing and re-credentialing processes with accuracy and efficiency. Your responsibilities will include: - Processing and maintaining credentialing and recredentialing applications for healthcare/dental providers. - Verifying licensure, education, training, certifications, and work history. - Communicating with insurance companies and state/federal agencies for timely enrollment. - Tracking and following up on credentialing applications to ensure deadlines are met. - Maintaining accurate and organized records in credentialing databases and systems. - Responding to credentialing-related...

Company Overview Total RCM Solutions is a premier revenue cycle management firm assisting healthcare providers across the USA. Established in 2018, our team collectively boasts over 100 years of expertise, offering tailored services that optimize practice operations. From comprehensive revenue cycle management to individualized solutions, we ensure adherence to coding guidelines and provide multilingual patient support, serving both healthcare entities and other RCM firms. Job Overview This full-time, hybrid role based in Bengaluru offers a mid-level position as an Insurance Credentialing Specialist. The successful candidate will have 4 to 6 years of experience in the field of credentialing....

Overview We're seeking a Provider/Payer Enrollment to manage the critical process of enrolling and credentialing healthcare providers with various insurance payers, including commercial, Medicare, and Medicaid plans. This role is essential for ensuring providers are able to bill for services and for maintaining a healthy revenue cycle. The ideal candidate will be highly organized and have a strong understanding of US healthcare regulations and credentialing processes. Responsibilities Enrollment and Credentialing: Prepare and submit provider enrollment applications, re-enrollments, and re-credentialing documents to commercial, Medicare, and Medicaid payers. Documentation Management: Maintain...

Candidates must be based out of Chennai and should be comfortable to attend face to face interview only should apply. NO VIRTUAL INTERVIEWS!! Job Summary: The Credentialing Specialist is responsible for verifying the credentials of healthcare providers, maintaining up-to-date records, and ensuring compliance with state, federal, and payer regulations. The role involves managing provider enrollment, re-credentialing, and communication with insurance payers and providers. Key Responsibilities: Collect, verify, and maintain provider credentials including licenses, certifications, education, and work history. Prepare and submit enrollment and re-enrollment applications to payers (Medicare, Medic...

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,...

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...

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...

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...

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...

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...

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...

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...

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...