Credentialing Specialist- Healthcare -Immediate joiner @ R Systems

Job Description

Job Title: Credentialing Specialist (Provider Enrollment)- Credentials.

Skills : Credentialing, Insurance Eligibility, Enrollment

Location : Pune ( Baner )

Education: Graduate.

Experience: 1-5 Years

Cab Facility : Both sides cab

Shift : 5:30 PM to 2:30 AM ( Voice Process)

Profile Overview: Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. Keep track of expiration dates for state DEA licenses, board certifications, and malpractice insurance for individual providers.

Key Responsibilities: Maintain individual provider files with up-to-date information for governmental and commercial payer credentialing applications. Track contracted Managed Care Organizations, commercial payers, CMS Medicare, Medicaid, PECOS, NPPES, and CAQH to ensure all portal logins are active and accessible. Collaborate with providers to ensure timely updates to their CAQH database files as per CMS Medicare/Medicaid and Managed Care Organizations regulations. Coordinate, monitor, and maintain the credentialing, re-credentialing, and contracting processes with insurance companies.

Please share resume at Si**********i@rs*****s.com

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Keyskills:   Credentialing CAQH Provider enrollement Enrollment US Healthcare NPPES RCM Insurance Eligibility