Credentialing Specialist

Role & responsibilities

Credentialing Specialist will work with the credentialing team in the United States to help physicians, medical practices, and healthcare organizations with credentialing and enrollment. The roles and responsibilities include:

• Track and follow up with providers for timely return of all required credentialing documents and applications
• Assist in synchronization of data among multiple systems
• Maintain credentialing database and ensure up-to-date tracking of application process
• Document progress in project management software, and provide regular updates to management
• Work with commercial and governmental payers for credentialing and enrolment of multiple provider specialties and facility types
• Stay up to date on licensing, verification, and state specific rules and bylaws to maintain compliance
• Display in depth knowledge of and execution of all standard operating procedures (SOPs) as well as communicating issues, trends, concerns, and suggestions to management
• Perform other duties as assigned

Preferred candidate profile

• Strong knowledge of the US healthcare landscape
• Basic medical billing and payer network skillset required
• Thorough knowledge of CAQH, with ability to document and prepare applications for healthcare providers
• Intermediate knowledge of provider hospital credentialing and hospital admitting privileges
• Ability to plan, prioritize, and complete work to meet established objectives
• Highly proficient with computers, especially Word and Excel
• Excellent written and oral English communication skills
• Positive attitude and an outgoing personality
• Ability to work night shifts

Experience: More than 1 years experience in provider credentialing and enrolment

Qualification: Graduate with relevant work experience required

Shifts: Night Shift (6:30 pm 4:00 am) Monday to Friday