Credentialing Specialist

Industry: US healthcare (Medical Billing)
Working Days: Monday - Friday
Job Timing: 7 pm - 2 am/8 pm - 3 am (During Daylight Saving)

Key Responsibilities:

• Prepare, review, and submit provider enrollment and credentialing applications to insurance companies, Medicare, and Medicaid.
• Maintain accurate records of provider data including NPI, CAQH, licenses, certifications, and other required documentation.
• Track application status and follow up with payers to ensure timely approval.
• Update and maintain CAQH profiles for all providers.
• Monitor expiration dates of licenses, DEA, malpractice insurance, and re-credentialing requirements, ensuring renewals are completed on time.
• Communicate with providers to collect necessary information and resolve discrepancies.
• Work closely with billing and revenue cycle teams to avoid claim denials due to credentialing issues.
• Prepare regular reports on credentialing and enrollment status.
• Ensure compliance with all federal, state, and payer requirements.

Job Type: Full-time

Pay: Rs60,000.00 - Rs80,000.00 per month

Education:

• Intermediate (Preferred)

Experience:

• Credentialing: 2 years (Preferred)

Work Location: Remote