Credentialing Specialist R Systems International

2.0 - 5.0 years

2 - 5 Lacs

pune

Work from Office

Job Title: Credentialing Specialist (Provider Enrollment)- Credentials. Skills : Credentialing, Insurance Eligibility, Enrollment Location : Pune ( Baner ) Education: Graduate. Experience: 2-5 Years Cab Facility : Both sides cab Profile Overview: • Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. • Keep track of expiration dates for state DEA licenses, board certifications, and malpractice insurance for individual providers. Key Responsibilities : • Maintain individual provider files with up-to-date information for governmental and commercial payer credentialing applications. • Track contracted Managed Care Organizations, commercial payers, CMS Medicare, Medicaid...

Posted 17 hours ago

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Eligibility Verification Specialist PwC Service Delivery Center

2.0 - 4.0 years

1 - 4 Lacs

bengaluru

Work from Office

Eligibility Verification Specialist Responsibilities: Verify patient insurance eligibility and benefits prior to scheduled visits or procedures. Confirm coverage for exams, diagnostic tests (OCT, visual fields, etc.), and surgical procedures. Document copays, deductibles, coinsurance, and authorization requirements. Communicate insurance details to patients and front office staff. Work with insurance carriers to resolve eligibility issues. Maintain up-to-date records for compliance and billing accuracy. Qualifications: 2 and above years of experience in medical eligibility verification. Familiarity with payer requirements. Strong communication and customer service skills. Ability to manage m...

Posted 2 weeks ago

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Credentialing Specialist MNR Solutions Pvt. Ltd.

1.0 - 5.0 years

0 Lacs

pune, maharashtra

On-site

As a Credentialing Specialist (Provider Enrollment) at our office in Pune, you will play a crucial role in maintaining accurate provider profiles on various databases such as CAQH, PECOS, NPPES, and CMS. With a minimum of 1-3 years of experience in credentialing, your primary responsibility will be to ensure that all provider profiles are up to date and compliant with regulatory requirements. Your key responsibilities will include collaborating with providers to update their CAQH files in accordance with CMS Medicare/Medicaid and Managed Care Organizations regulations. Additionally, you will be responsible for monitoring and maintaining the credentialing, re-credentialing, and contracting pr...

Posted 1 month ago

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