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
