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TL-Provider Credentialing

TL-Provider Credentialing

Cognizant

6 - 8 years

15 - 25 Lacs

hyderabad

Posted:9 hours ago| Platform:

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Skills Required

process providing data analysis us healthcare interpersonal skills healthcare bpo healthcare claims processing payment posting re ar calling charge entry denial management credentialing claims medical billing rcm revenue cycle management communication skills

Work Mode

Work from Office

Job Type

Full Time

Job Description

Job Summary

We are seeking a dedicated professional for the role of TL-Provider Credentialing with 6 to 8 years of experience. The ideal candidate will have expertise in HealthCare Products and a strong background in Revenue Cycle Management Credentialing and Re-credentialing. This hybrid role requires working night shifts and offers an opportunity to make a significant impact on our healthcare operations.

Responsibilities

Oversee the provider credentialing process to ensure compliance with industry standards and regulations.

Coordinate with healthcare providers to gather necessary documentation for credentialing and re-credentialing.

Analyze and verify provider information to maintain accurate and up-to-date records.

Collaborate with internal teams to streamline the credentialing workflow and improve efficiency.

Monitor and track credentialing applications to ensure timely completion and approval.

Provide guidance and support to providers throughout the credentialing process.

Develop and implement strategies to enhance the credentialing process and reduce turnaround times.

Ensure adherence to all regulatory requirements and organizational policies related to credentialing.

Conduct regular audits of credentialing files to maintain data integrity and compliance.

Communicate effectively with providers and stakeholders to address any credentialing-related inquiries or issues.

Utilize healthcare product knowledge to optimize credentialing procedures and outcomes.

Contribute to the development of best practices and standard operating procedures for credentialing.

Support the revenue cycle management team by ensuring accurate provider information is available for billing and claims processing.

Qualifications

Possess a strong understanding of healthcare products and their application in credentialing processes.

Demonstrate expertise in revenue cycle management with a focus on credentialing and re-credentialing.

Exhibit excellent communication and interpersonal skills to interact with providers and stakeholders.

Show proficiency in data analysis and verification to maintain accurate provider records.

Have experience in developing and implementing process improvement strategies.

Display knowledge of regulatory requirements and industry standards for credentialing.

Be capable of conducting audits and maintaining data integrity in credentialing files.

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TL-Provider Credentialing