Senior Credentialing Specialist
1 week ago
About AlphaBillingUS:
AlphaBillingUS is a U.S. based medical billing and healthcare solutions company with operations managed globally. We specialize in medical billing, insurance credentialing, revenue cycle management, and digital marketing for healthcare providers. Our mission is to simplify healthcare operations by delivering reliable, compliant, and high-quality services to medical practices and healthcare professionals.
Job Description:
We are seeking an experienced and detail oriented Credentialing Specialist to join our growing team at AlphaBillingUS. The Credentialing Specialist will handle all aspects of provider credentialing and enrollment with insurance companies and healthcare organizations. This role requires excellent communication skills as you will occasionally join calls with clients to address credentialing-related questions before contracts are finalized.
Key Responsibilities:
Manage the end to end credentialing and enrollment process for providers, including applications, document collection, and submissions to insurance payers and healthcare organizations.
Maintain accurate and up-to-date provider credentialing data in systems (CAQH, NPPES, payer portals, etc.), ensuring compliance with regulations.
Monitor credentialing status and follow up with payers to expedite approvals.
Join client calls (pre-contract) to answer technical credentialing questions and build trust with prospective clients.
Coordinate with billing, contracting, and operations teams to ensure seamless onboarding of new providers.
Assist with re-credentialing and re-enrollment processes for existing providers.
Stay updated with industry standards, compliance regulations, and credentialing requirements.
Collaborate with the contracting team to support insurance contract negotiations when needed.
Requirements:
Bachelor's degree in Healthcare Administration, Business Administration, or related field (preferred).
Minimum 2+ years of experience in provider credentialing/enrollment (healthcare or medical billing environment).
Strong knowledge of CAQH, NPPES, PECOS, Medicare/Medicaid, and payer-specific portals.
Familiarity with healthcare compliance standards and payer credentialing policies.
Excellent communication skills (written and verbal), especially in explaining technical credentialing processes to clients.
Strong organizational skills with attention to detail; ability to manage multiple applications simultaneously.
Ability to work independently as well as collaboratively in a team environment.
Commitment to confidentiality and compliance with HIPAA standards.
Why Join Us?
Competitive salary (based on experience).
Paid time off and holidays.
Opportunities for professional growth and training.
Be part of a growing healthcare solutions company making a difference in the U.S. healthcare system.
If you are passionate about healthcare operations, thrive in a fast-paced environment, and have a proven track record in credentialing, we'd love to hear from you.
Apply now and be part of the AlphaBillingUS team
Job Type: Full-time
Projected Total Compensation: Rs100, Rs150,000.00 per month
Work Location: In person
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