Credentialing Specialist
Total RCM Solutions
- Bangalore, Karnataka
- Permanent
- Full-time
- Proven experience in credentialing and re-credentialing processes within the healthcare industry.
- Thorough knowledge of healthcare regulations, compliance standards, and payor requirements.
- Excellent communication skills, both verbal and written, with the ability to interact with various stakeholders.
- Strong organizational skills and attention to detail for managing credentialing documents and timelines.
- Ability to handle sensitive information with confidentiality and professionalism.
- Proficient in using healthcare management systems and technology solutions for credentialing tasks.
- Adaptability and problem-solving skills to address complex credentialing issues promptly.
- Must have a customer-oriented approach to ensure seamless interactions with healthcare providers.
- Manage and maintain the credentialing files for all healthcare providers within the network.
- Ensure timely re-credentialing by monitoring expirations and keeping track of necessary renewals.
- Coordinate with healthcare providers to obtain all required documentation for credentialing purposes.
- Review and verify professional eligibility, certifications, and licenses according to industry standards.
- Communicate with payors and other entities to facilitate successful enrollment and network participation.
- Keep informed about changes in credentialing regulations to ensure compliance and efficiency.
- Provide support to healthcare providers by resolving credentialing inquiries and issues effectively.
- Contribute to the ongoing development and improvement of credentialing processes and systems.
Expertia AI Technologies