Credentialing Specialist I

IHCS Technologies India Private Limited

Vadodara

2-5 Years

3.5 - 6 LPA

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Job Description

Job Description
Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients. Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.
This is an onsite position, 5 days/week, in Vadodara office-Gujarat
Shift: - NIGHT/US SHIFT. Hours are 6:30pm-3:30am IST.
Remote applicants will not be considered.
Responsibilities:
- Coordinate and manage the credentialing and re-credentialing process for healthcare providers, including physicians, nurses, therapists, and other allied health professionals.
- Collect and review provider credentialing applications, ensuring accuracy and completeness of information.
- Verify provider credentials, including education, training, licensure, certifications, and professional experience, through primary sources and credentialing databases.
- Communicate with healthcare providers, licensing boards, professional organizations, and insurance carriers to obtain necessary documentation and resolve credentialing issues.
- Maintain accurate and up-to-date provider credentialing files and databases, ensuring compliance with regulatory standards and accreditation requirements.
- Monitor and track credentialing status and expirations, initiating re-credentialing processes as needed to maintain provider network participation.
- Collaborate with internal departments, including billing, compliance, and human resources, to ensure timely credentialing and enrollment of providers.
- Stay informed about changes in credentialing standards, regulations, and industry best practices, and incorporate updates into credentialing processes and procedures.
- Assist with special projects and initiatives related to provider credentialing and network management as assigned.
Qualifications:
- Bachelor's degree in healthcare administration, business administration, or related field preferred.
- 2 years of experience in credentialing and provider enrollment, preferably in a healthcare or RCMS setting.
- Proficiency in credentialing software and databases, such as CAQH, NPPES, and payer-specific enrollment portals is a plus.
- Excellent organizational skills and attention to detail, with the ability to manage multiple priorities and meet deadlines in a fast-paced environment.
- Effective communication and interpersonal skills, with the ability to collaborate with internal and external stakeholders.
- Knowledge of medical terminology, healthcare billing, and reimbursement processes is a plus.
If you are a motivated professional with experience in credentialing and provider enrollment, we invite you to apply for the Credentialing Specialist position and join our dynamic team in the RCMS industry.
Additional Job Description
Additional Job Description

More Info

Job Type:

Permanent Job

Industry:

Health Care, Electronic Health Record (EHR)

Role:

Other Roles

Function:

Others

Employment Type:

Full time

Open to candidates from:

Indian

About Company

IHCS Technologies India Private Limited

Greetings from IHCS Technologies India Private Limited.

About Us:-

Insync HCS is an EHNAC accredited health care technology company that works closely with providers, payers and others in the industry to increase electronic healthcare transactions between the parties utilizing the Insync HCS suite of products.

Formerly known as MDOL, Insync HCS is a leading provider of EMR and Practice Management system, Medical Transcription service and Revenue Cycle Management service to thousands of healthcare facilities throughout the United States. Our customer base ranges in size from physician practices to some of the largest and most prestigious medical centers in the nation.

Based in Parsippany, New Jersey, the Insync HCS team is committed to continuing its exceptional growth by delivering a standard of excellence that customers and investors expect.

Job ID: 147158161