Credentialing & Enrollment Professional

CTB Solutions; Chennai; Sur place; INR 600 000 - 1 200 000; Plein temps

Résumé du poste

CTB Solutions in Chennai is seeking an experienced Credentialing Specialist to maintain and verify credentialing data for practitioners. You will enroll providers with payers, resolve credentialing issues, and support audits.

The role requires at least 5 years in healthcare credentialing, strong knowledge of NCQA standards, and excellent communication skills. You will lead process improvement and supervise junior staff, ensuring high data integrity in a fast-paced environment.

Qualifications

• Bachelor's degree in healthcare administration, business, or related field.
• Minimum of 5 years of experience in healthcare credentialing and provider enrollment.
• Knowledge of state, federal, and accreditation regulations related to credentialing.
• Familiarity with NCQA standards and guidelines.
• Proficiency with credentialing databases and Microsoft Office Suite.
• Excellent communication and interpersonal skills.
• Ability to multitask and prioritize in a high-volume, fast-paced environment.
• Strong attention to detail, organizational skills, and ability to meet deadlines.

Responsabilités

• Ensure accurate maintenance, verification, and processing of credentialing data for all practitioners as per the standards set by regulatory bodies.
• Handle provider enrollment with insurance payers for all new and existing providers.
• Serve as the primary contact for all issues related to provider credentialing and enrollment.
• Develop and maintain strong professional relationships with providers, healthcare facilities, and payers.
• Provide credentialing support during audits and compliance reviews.
• Lead process improvement initiatives in the credentialing department.
• Regularly update, maintain, and review the credentialing database ensuring data integrity.
• Train and supervise junior credentialing staff, providing guidance and support as needed.

Connaissances

Communication skills

Multitasking

Attention to detail

Team leadership

Data integrity

Formation

Bachelor's degree in healthcare administration or related field

Outils

Credentialing databases

MS Office

Description du poste

Responsibilities:

• Ensure accurate maintenance, verification, and processing of credentialing data for all practitioners as per the standards set by regulatory bodies.
• Handle provider enrollment with insurance payers for all new and existing providers.
• Serve as the primary contact for all issues related to provider credentialing and enrollment.
• Develop and maintain strong professional relationships with providers, healthcare facilities, and payers.
• Provide credentialing support during audits and compliance reviews.
• Lead process improvement initiatives in the credentialing department.
• Regularly update, maintain, and review the credentialing database ensuring data integrity.
• Train and supervise junior credentialing staff, providing guidance and support as needed.

Qualifications:

• Bachelors degree in healthcare administration, business, or related field.
• A minimum of 5 years of experience in healthcare credentialing and provider enrollment.
• Knowledge of state, federal, and accreditation regulations related to credentialing.
• Familiarity with National Committee for Quality Assurance (NCQA) standards and guidelines.
• Proficiency with credentialing databases and Microsoft Office Suite.
• Excellent communication and interpersonal skills.
• Ability to multitask and prioritize in a high-volume, fast-paced environment.
• Strong attention to detail, organizational skills, and ability to meet deadlines.