Credentialing Specialist

Credentialing Administrator

Responsibilities

• Check Deal Log by-weekly for new offices opening dates.
• Obtain IRS Confirmation from Development Department.
• Confirm with VP of Operations whos the Owner/Billing Provider.
• Verify copies of current credentials on file for Owner/Billing Provider.
• Request NPI Type 2 (Billing Entity NPI).
• Complete applications and contracts for Billing Provider and submit for signatures.
• Review signed contracts for accuracy.
• Submit the paperwork within 24 hours to the applicable plans for approval and acceptance into their networks.
• Update credentialing process on Pending Log.
• Follow up with Dental Plans.
• Process billing changes (ownership changes, pc changes, TIN changes).
• Credentialing, Owners, associates and specialist as required.
• Maintain Insurance Provider Status Report and Provider Files with Current Credentials.
• Check, open, and send inbound / outbound mail.
• Filing and Scanning.
• Communicate issues and suggestions to improve processes.
• Ensure compliance with Company policies, as well as State, Federal and other regulatory bodies.

Other Details

5 Days Working

2 Days Off

Location - Gurgaon

Salary max upto 5.50LPA

Qualification - Graduate