CREDENTIALING SPECIALIST & COORDINATOR
Experience: 3+ year of US healthcare experience in Lab credentialing
Location: Remote (Work from home)
Shift: US Shift (6:30pm - 3:30am IST)
ROLES AND REPONSIBILITIES:
Collect all the data and documents required for filing credentialing applications from the providers. Complete providers credentialing and re-credentialing applications; monitor applications and follow-up as needed
Maintain knowledge of current health plan requirements for credentialing process. Stay up to date on licensing, verification, and state specific rules and bylaws to maintain compliance
Maintain current and accurate data for all providers. Ensure practice addresses/Phone number/ Fax Number are current with health plans
Track license and certification expirations for all providers to ensure timely renewals
Work with commercial and governmental payers for credentialing and enrolment of multiple provider specialties and facility types (Medicare, Medicaid and commercial insurances)
Display in depth knowledge of and execution of all standard operating procedures (SOPs) as well as communicating issues, trends, concerns, and suggestions to management Identifying discrepancies in information and conducting follow-ups
Maintain copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers
Ensure that facility/providers comply with federal and state regulations regarding licensure Maintain credentialing database and ensure up-to-date tracking of application process
JOB REQUIREMENT
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