Credentialing Specialist(Provider Side)

Job Description

Job description Credentialing Specialist(Provider Side) We are looking for a Fresher/Experienced Credentialing Specialist(Provider Side) to join our medical billing team for the Mid shift. The ideal candidate will have 1-4 years of experience in medical billing with a strong focus on Credentialing Process(Provider Side). Job Role: Credentialing Enrollment(Provider Side) Designation: Credentialing Specialist Qualification: Any UG & PG Degree/Diploma Exp:0-4 Years Location: Okkiyampettai ,Thoripakkam, Chennai Shift timings: Mid Shift (12:00 pm - 9:00 pm) Working Days: Monday to Friday Freshers are also eligible to apply for this job. Key Responsibilities: Submit and track credentialing applications to insurance carriers and other healthcare payers. Maintain accurate provider records and update information with insurance companies, including NPI, malpractice, and licensure data. Communicate with insurance companies over the call and e-mails to resolve any issues or discrepancies in provider credentials. Verify the accuracy and completeness of documentation submitted for credentialing and re-credentialing. Ensure timely renewal of provider contracts with insurance companies and government payers (e.g., Medicare, Medicaid). Act as a liaison between healthcare providers, insurance carriers, and internal teams to resolve credentialing issues. Monitor and manage credentialing status for providers to ensure continued participation in insurance networks. Ensure compliance with regulatory requirements for insurance credentialing and maintain current knowledge of industry best practices. Maintain and update credentialing databases and systems. Prepare reports on credentialing activities and status for management. Qualifications: 1-3 years of experience in insurance Credentialing (Provider Side) or healthcare administration. Strong knowledge of insurance credentialing processes, including experience with Medicare, Medicaid, and commercial insurance plans. Familiarity with the CAQH and National Provider Identifier (NPI) system, and related healthcare regulations. No cab facility is provided, Candidates are required to arrange their own transportation. Interested candidates please contact Saranya Devi(HR)- 7200153996 (Interview days- Monday to Friday)