Healthcare Provider Credentialing Expert

6 hours ago

Rawalpindi Cantonment, Pakistan beBeeCredentialing Full time
Medical Credentialing Specialist

At our medical services organization, we're seeking a skilled Medical Credentialing Specialist to join our team.

This role is responsible for verifying and maintaining the credentials of healthcare providers, ensuring compliance with regulations, and assisting with the credentialing process to support billing and insurance claims.

The ideal candidate will have a strong attention to detail, knowledge of credentialing processes, excellent communication skills, and proficiency in medical credentialing software.

In this role, you'll be responsible for:

  • Verifying the credentials of healthcare providers, including education, training, certifications, and licensure.
  • Ensuring that healthcare providers meet the credentialing requirements of insurance companies and government programs like Medicare and Medicaid.
  • Managing and tracking provider credentialing applications, submissions, and renewals.
  • Coordinating with insurance payers to ensure timely and accurate credentialing and recredentialing.
  • Maintaining accurate records of provider credentials and ensuring compliance with regulatory and payer requirements.
  • Assisting providers with any necessary documentation or steps in the credentialing process.
  • Reviewing and ensuring that all credentialing paperwork is complete and up-to-date.
  • Working closely with healthcare providers and insurance companies to resolve any credentialing-related issues.
Requirements:
  • Education: Bachelor's degree or equivalent experience in healthcare administration or a related field.
  • Experience: 2-3 years of experience in medical credentialing or healthcare administration.
  • Skills: Strong attention to detail, knowledge of credentialing processes, excellent communication skills, and proficiency in medical credentialing software.
  • Other Requirements: Understanding of healthcare regulations, payer requirements, and compliance standards like HIPAA.

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