Certified Credentialing Specialist

Handle credentialing needs for our clients (Group and/or Individual) who are US-based health care providers, diagnostic laboratories and medical facilities as preferred providers in health care networks.

This entails the following tasks:

• Perform credentialing work:
• Collect all the required documentation for credentialing such as accreditation, membership and facility privileges (e.g., License, NPI letter).
• Assist providers with completing payer forms and ensure compliance with payer s expectations
• Respond to provider s inquiries as to credentialing process progress
• Alert client of new regulations, expiring certificates, reapplications and deficiencies in credentialing requirements
• Maintain accurate and current client information using an online database
• Drive the implementation of the automated credentialing workflow management system:
• Provide requirements to software developers
• Review implementation

QUALIFICATIONS

1. At least 2 years experience in US-based Credentialing process
2. Familiar with US medical insurance industry
3. Excellent listening, communication, and problem-solving skills
4. Self-motivated and able to work autonomously
5. Credentialing certification is required

MUST HAVE :

1. High comfort level working on Eastern Time Zone/US Shift
2. Good internet access at home
3. Mobile Hotspot
4. Laptop/Desktop of at least 8 GB