Credentialing Specialist

Job description:

Credentialing Specialist
Preferred Experience: 1-4years

Ideal candidate must have followed:

• Perform all new provider credentialing, existing provider recredentialing, and personal and demographic updates for providers and groups.
• Track all activities in the process of credentialing/recredentialing providers and clinics.
• Ensure that all credentialing/recredentialing dates are fully complied with and nothing gets missed or lapsed.
• Coordinating with other operations team such as billing, coding, finance to ensure all commercial terms of credentialing contracts are followed.
• Interact with US-based practice owners and clinicians on completing and correcting any missing or incorrect data on their insurance claims.
• Developing and modifying workflow process flows as per company requirements. Assisting RCM staff in resolving credentialing and provider enrollment issues.
• This also includes outstate applications.
• Assisting consultants with contracting correspondence and follow-up. Should be comfortable with voice process and interacting with US based onsite team or clients.
• Responsible for generating daily production or worksheet reports as assigned by management.
• Publishing regular credentialing status reports and metrics for customers.

Required Candidate profile. .

• Basic understanding of CPT and ICD9 coding experience including use of modifiers and HCPCS codes.
• Basic knowledge of collection laws, rules, and regulations.
• Client Account Management/Client Interaction experience will be a big plus.
• Knowledge of medical billing or credentialing software, preferably Kareo, Modio or any other similar.
• Knowledge of medical billing and medical coding will be big plus.
• Excellent knowledge of Microsoft 365 office applications like Teams, Outlook, Excel, Word, ppt, CRM Dynamics, OneDrive, Visio etc.

Competencies:

• Excellent verbal and written English business communication skills for interacting with USA based team members/ physicians/vendors/patients.
• Professional and able to make a great impression on the phone. Required to understand, communicate & work regularly with USA based team.
• Candidates must be based out of Chandigarh Tricity or nearby areas like Himachal, Punjab.
• Must have long term association with Chandigarh Tricity area.
• Ability to work well with others and facilitate teamwork and cooperation. Positive attitude and able to follow directions.
• Willing to cross train and cross learn other areas of RCM.
• Tact, diplomacy, and the ability to maintain confidentiality of company, client, and patient information.
• Must have very strong work ethic and excellent attention to detail.

Job Types: Full-time, Permanent

Pay: ₹25,000.00 - ₹35,000.00 per month

Benefits:

• Provident Fund

Work Location: In person