Credentialing Coordinator

4 days ago

Karachi, Sindh, Pakistan beBee Careers Full time

About the Role:

This position involves overseeing the entire credentialing process, from initial applications to ongoing maintenance and re-credentialing for healthcare providers. It requires a strong understanding of medical billing, coding practices, and healthcare regulations.

Responsibilities
  • Manage and submit enrollment applications to various insurance carriers and government agencies.
  • Verify and maintain accurate provider information, including licenses, certifications, and insurance policies.
  • Maintain organized records of credentialing documents, expirations, and updates.
  • Liaise with insurance companies, healthcare providers, and relevant parties to resolve credentialing issues and inquiries.
  • Stay up-to-date with industry regulations and insurance requirements to ensure provider compliance.
  • Identify and address obstacles or challenges in the credentialing process promptly and effectively.
  • Collaborate with other teams to resolve issues related to provider credentialing.
Requirements
  • A minimum of 3 years of experience in healthcare credentialing or related fields.
  • Strong knowledge of medical billing, coding practices, healthcare regulations, and insurance policies.
  • Experience in RPM billing is preferred.
  • Bachelor's Degree in Computer Science, Healthcare Administration, or Commerce-related fields is preferred.
  • Proficiency in GSuite, Slack, and excellent problem-solving and organizational skills.
  • Solid understanding of billing software and electronic medical records.
  • Exceptional communication and time management skills.
  • Attention to detail is essential.
  • Ability to work independently and manage multiple projects simultaneously.
KPIs
  • Application Processing Time: Submit applications within 24-48 hours of request.
  • Application Accuracy: Aim for 95–100% accuracy, with minimal corrections needed.
  • Application Approval Rate: Achieve a 95% approval rate on first submission.
  • Timely Follow-Up: Promptly follow up on additional documentation requests.
  • Weekly Reports: Provide a weekly summary of application statuses and follow-ups.
Benefits
  • Healthcare insurance with comprehensive coverage.
  • Company-paid lunch or dinner shifts.
  • Annual leave and casual or sick leave.
  • Paid professional development training and certifications if required.

Job Details

This role offers opportunities for career growth and professional development in the healthcare industry. If you are a motivated and detail-oriented individual with experience in healthcare credentialing, we encourage you to apply.

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