Senior Associate - Credentialing

IN01 Mdeverywhere India PVT LTD.; Sector 10; On-site; INR 600,000 - 900,000; Full time

Benefits offered by this job

Health insurance

Job summary

CompuGroup Medical, a leader in digital healthcare solutions, seeks a Senior Associate - Credentialing to join its Noida onsite team. The role focuses on credentialing processes, CAQH proficiency, and provider enrollment for US RCM, ensuring regulatory compliance and timely credentialing activities.

You will collaborate with the Credentialing Manager, verify data accuracy, and coordinate with internal/external teams to maintain high standards and service quality.

Qualifications

• Minimum 2 years of experience in Credentialing in US RCM industry.
• Knowledge in CAQH modules, provider enrollment.
• Expertise with CAQH.
• Graduate required.
• Basic knowledge about Internet concepts, Windows, Microsoft, and Adobe products.
• Strong documentation and presentation skills.
• Flexible to work in shifts as per business needs.

Responsibilities

• Ensure credentialing processes comply with professional standards, bylaws, state and federal regulations.
• Oversee day-to-day credentialing and privileging activities.
• Collaborate with Credentialing Manager to ensure policies and procedures are followed.
• Act as SME, resolve issues, coordinate with credentialing contacts.
• Verify primary source data such as education, board certifications, licensure, and eligibilities.
• Ensure timely credentialing and re-credentialing of network providers, maintain timelines and compliance.
• Contact payers for enrollment status and take necessary actions.

Skills

Credentialing

CAQH

Provider enrollment

Documentation

Presentation skills

Shift flexibility

Education

Graduate

Tools

Windows

Microsoft Office

Adobe products

Job description

Create the future of e-health together with us by becoming a Senior Associate - Credentialing at CompuGroup Medical

CompuGroup Medical, our mission is to build groundbreaking solutions for digital healthcare. We aim to revolutionize how healthcare professionals produce, access and utilize information, enabling them to focus on the core value of their work: patient outcomes. As one of the Best in KLAS organizations in the industry, we offer a full scope of Electronic Health Records (EHR), Billing, Payment services and Revenue Cycle Management (RCM) services. We provide our team members with the training and solutions to grow across various technologies and processes.

What you can expect from us:

• High Performing Team: You will be part of a close-nit, elite team within CGM that will move fast, with accuracy and hit deadlines with confidence.
• In-Person Team Environment: The role and the team will be onsite in Noida. We’re making work human again. No more working with people that you never meet in person. In this role, you will build in-person relationships with your team, and friendships for years to come.
• Comprehensive Benefits: Extensive group health and accidental insurance programs.
• Seamless Onboarding: A safe digital application process and a structured onboarding program.
• Engagement Activities: Tons of fun at work with engagement activities and entertaining games.
• Career Growth: Various career growth opportunities and a lucrative merit increment policy.
• Flexible Transportation: Choose between a self-transport allowance or our pick-up/drop-off service.
• Subsidized Meals: Enjoy our kitchen and food hall with subsidized meals, for your convenience.

Key Responsibilities & Duties:

• Ensure credentialing processes are following professional standards, bylaws, state and federal regulatory requirements.
• Oversee day-to-day operational credentialing and privileging activities.
• Collaborating with the Credentialing Manager to ensure proper functioning of activities, policies, and procedures.
• Acting as a resource and subject matter expert, resolving issues, Coordinating with Credentialing contacts regarding the credentialing process.
• Verifying primary source data, such as provider education, board certifications, licensure, and other eligibilities/documents.
• Ensuring timely credentialing and re-credentialing of network providers and working with Internal/External Team to ensure credentialing files completed within timeframe and compliance.
• Calling Payers for Enrollment application status and take necessary action.

Qualification/Experience:

• Minimum 2 years of experience in Credentialing in US RCM industry.
• Should have knowledge in CAQH modules, provider enrollment.
• Overall, should be expertise with CAQH.
• Candidate should be a graduate.
• Basic knowledge about Internet Concepts, Windows, Micorsoft ,Adobe products.
• Should possess strong documentation and presentation skills.
• Should be flexible to work in shifts, based on business need.

We create the future of e-health.

CGM is one of the leading e-health companies in the world with more than 8.700 highly qualified employees Sustainable solutions for constantly growing demands in healthcare Locations in 19 countries and products in 60 countries worldwide