Professional, Provider Enrollment (Multiple)

Advantum Health; Dadri; On-site; INR 350,000 - 600,000; Full time

Job summary

Advantum Health is seeking a Professional - PES with 2–4 years of end-to-end credentialing experience. You will manage provider enrollment, contracting and re-credentialing, ensuring CAQH updates and adherence to CMS schedules.

Strong knowledge of US credentialing and HIPAA compliance is required, along with excellent communication and Microsoft Office skills. This role emphasizes accurate records and timely renewals.

Qualifications

• 2-4 years of experience in end-to-end provider enrollments and insurance credentialing.
• Strong knowledge of US Credentialing and its impact on revenue cycle.
• Excellent written and verbal communications; HIPAA compliance.

Responsibilities

• Maintain provider files for governmental and commercial credentialing applications.
• Update CAQH databases according to CMS schedules.
• Complete credentialing for commercial payers, Medicare and Medicaid.
• Maintain provider information in online credentialing systems.
• Track license and certification expirations and renewals.
• Ensure addresses and documents are current and securely stored.
• Achieve daily/weekly/monthly targets for the individual.

Skills

Execution and Delivery

Reports

Dependability

Attendance

HIPAA

Communication Skills

Job Knowledge

Quality

Productivity

Customer Focus

Tools

Microsoft Office

Job description

Professional - PES

2-4 Years of experience in end-to-end process of Provider Enrollments/ Insurance Credentialing, Provider Contracting, and Re-Credentialing.

Strong knowledge of US Credentialing

Knowledge of provider credentialing and its direct impact on the practice s revenue cycle.

Adhere to organizational policies and procedure.

Ability to prioritize and manage work queue.

Knowledge of Microsoft Office (Word, Excel, Outlook).

Excellent written and verbal communications.

Essential Functions

Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications.

Maintain internal provider grid to ensure all information is accurate and logins are available.

Update each provider s CAQH database file timely according to the schedule published by CMS.

Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid etc.

Maintains knowledge of current health plan and agency requirements for credentialing providers.

Sets up and maintains provider information in online credentialing databases and system.

Tracks license and certification expirations for all providers to ensure timely renewals.

Ensures practice addresses are current with health plans, agencies, and other entities.

Store the documents centrally on our secure document management systems.

Periodic update of the document library for credentialing purpose.

Maintain strict confidentiality in accordance with HIPAA regulations and company policy.

Meeting daily/weekly and monthly targets set for an individual

Required Skills

• Execution and Delivery
• Reports
• Dependability
• Attendance
• HIPAA
• Communication Skills
• Job Knowledge
• Quality
• Productivity
• Customer Focus