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Post
Credentialing Specialist
Job Category: Administrative/Support
Requisition Number: CREDE002085
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Posting Details
Showing 1 location
India- Bangalore
Zinnia, Outer Ring Rd
7th Floor, Block 8c
Karnataka, IND 560103, IND
India- Bangalore
Zinnia, Outer Ring Rd
7th Floor, Block 8c
Karnataka, IND 560103, IND
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Job Details
Description
Roles & Responsibilities
Voice Process / Semi-Voice Process
- Contact insurance payers to verify credentialing and enrollment status.
- Follow up on pending credentialing and re-credentialing applications.
- Communicate with providers regarding missing documents and application updates.
- Resolve credentialing-related issues through phone calls and emails.
- Maintain detailed call logs and updates in the credentialing system.
- Coordinate with insurance representatives to expedite applications.
- Process provider credentialing and enrollment applications.
- Complete CAQH profile updates and attestations.
- Prepare, submit, and track payer enrollment requests.
- Maintain provider files, licenses, certifications, and supporting documents.
- Monitor credentialing expirations and ensure timely renewals.
- Handle email communication with providers and payers.
- Update credentialing databases and generate status reports.
Required Skills
- Knowledge of US Healthcare Credentialing and Provider Enrollment.
- Experience with CAQH, Medicare, Medicaid, and Commercial Payers.
- Strong communication and interpersonal skills.
- Good analytical and problem-solving abilities.
- Proficiency in MS Office, especially Excel.
- Ability to manage multiple tasks and meet deadlines.
- Excellent documentation and follow-up skills.
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