Credentialing Specialist

About Company:

CrystalVoxx Ltd, a KPO providing end to end service in Revenue Cycle Management (RCM), Credentialing, Medical Coding, Medical Transcription, Virtual Assistance to doctors / providers in US Healthcare Industry.

• Location:- Ahmedabad

• Shift:- 6:30 PM to 3:30 AM

• Working Days:- Monday to Friday

Roles & Responsibilities:

• Completes providers credentialing, re-credentialing applications; monitors applications, and follows-up as needed.
• Maintains knowledge of current health plan requirements for credentialing process.
• Tracks license and certification expirations for all providers to ensure timely renewals.
• Ensures practice addresses / Phone number / Fax Number are current with health plans.
• Identifying discrepancies in information and conducting follow-ups.
• Responding to health plan provider inquiries.
• Ensure that facility/providers comply with federal and state regulations regarding licensure.
• Ensure that health-care providers update their certification or licensing on time.
• Create NPPES (National Plan and Provider Enumeration System) and profiles for Medicare and NPI (National Provider Identification)
• Creates and maintains CAQH (Council for Affordable Quality Healthcare) accounts.
• Evaluates and maintains positive working relationships with outside credentialing partners, including health plans, field leadership.

Skills required:

• Experience in Medical Billing / AR experience required.
• Minimum 1-2 years credentialing experience is additional.
• Proficient with Windows, MS Office, Outlook, and Internet Explorer
• Excellent time management and organizational skills
• Excellent written and verbal communication skills