Credentialing Analyst For HOM

Openings: 1

Experience: 1-3 Years

Location: A76, Sector 136, Noida, Uttar Pradesh 201305

• Reviews practitioner registration forms and applications for completeness and collects data within defined timeframes.
• Reviews and documents findings of practitioner performance and credentials.
• Supports client onboarding and set up of provider profile.
• Helps training staff on Credentialing and Contracting processes.
• Prepares summaries for missing information request, notes for tasks and peer review.
• Prepares final committee-ready credentialing provider files for delegated clients.
• Adheres to strict confidentiality guidelines and Code of Conduct standards; conforms to defined processes in compliance with quality standards and regulatory requirement.
• Creates and enters practitioner data into profile, CAQH, provider portal, applications and group applications in credentialing software and obtains missing information and/or documents required, as needed.
• Sends expired license, insurance, etc. notifications to providers.
• Updates provider records with current license, insurance, COI, DEA, etc.
• Mails re-credentialing applications to providers, Health plans and logs receipt of recredentialing applications. Organizes provider files and re-credentialing files.

Only those candidates may apply who:

• Analytical - Synthesizes complex or diverse information; Collects and researches data.
• Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skilfully; Develops alternative solutions; Works well in group problem solving situations. The ability to break a complex problem down into its component parts and arrive at the appropriate solution in a timely fashion.
• Written Communication - Writes clearly and informatively; Edits work for spelling and grammar; Varies writing style to meet needs; Presents numerical data effectively; Able to read and interpret written information. Must type at least 30 words per minute
• Quality Management - Looks for ways to improve and promote quality; Demonstrates accuracy and thoroughness. Assumes responsibility for providing the highest level of quality to members and providers.
• Language Skills - Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
• Previous experience in Managed Care and Medicare preferred, though not required
• Have a basic knowledge of Microsoft Office (MS Excel and MS Word).
• Are interested in being part of a team dedicated to delivering quality work.
• Maintain a high degree of professional and ethical standards.

• Transportation Services: Nodal point-specific pick-up and drop-off services are provided at no cost.
• Subsidized Meals: Meals for team members within company premises.
• Insurance: Mediclaim and Accidental Health Insurance.

1. The first round would be virtually on Microsoft Teams with talent(HR) and tech teams.
2. The second step upon selection is for Documentation and Salary Negotiation, occurring the applicant s qualification in both rounds.

The recruitment process may be subject to change as well. Please contact the Talent team(HR) in case of any queries.