Credentialing Specialist

About XenMD:

XenMD is a leading healthcare services company dedicated to providing comprehensive solutions to medical practices, hospitals, and healthcare professionals. We specialize in revenue cycle management, practice management, and consulting services, helping our clients navigate the complexities of the healthcare industry with efficiency and expertise.

Job Description:

We are seeking a highly motivated and detail-oriented Credentialing Specialist to join our team at XenMD. The Credentialing Specialist will be responsible for managing all aspects of provider credentialing and enrollment with various insurance companies and healthcare organizations. This role requires exceptional organizational skills, attention to detail, and the ability to effectively communicate with internal teams and external stakeholders.

Responsibilities:

1. Manage the credentialing and enrollment process for new providers, including completing applications, gathering required documentation, and submitting applications to insurance companies and healthcare organizations.
2. Maintain accurate provider credentialing data in our systems and databases, ensuring compliance with all regulatory requirements and standards.
3. Monitor the status of credentialing applications and follow up with insurance companies and healthcare organizations to expedite the credentialing process.
4. Coordinate with internal teams, including billing and operations, to ensure timely completion of credentialing tasks and seamless integration of new providers into our systems.
5. Respond to inquiries from providers and internal stakeholders regarding credentialing status, requirements, and processes.
6. Stay informed about changes and updates to credentialing requirements, regulations, and industry best practices.
7. Assist with provider re-credentialing and re-enrollment processes to ensure continued participation with insurance networks and healthcare organizations.
8. Collaborate with the contracting team to negotiate provider contracts and agreements with insurance companies and healthcare organizations as needed.

Requirements:

1. Bachelor's degree in healthcare administration, business administration, or related field preferred.
2. Minimum of 2 years of experience in provider credentialing and enrollment, preferably in a healthcare or medical billing environment.
3. Proficiency in credentialing software and databases, such as CAQH, NPPES, and payer-specific credentialing portals.
4. Strong understanding of healthcare regulations, compliance standards, and credentialing requirements.
5. Excellent communication skills, both written and verbal, with the ability to effectively interact with providers, insurance companies, and internal teams.
6. Exceptional organizational skills and attention to detail, with the ability to manage multiple tasks and prioritize deadlines effectively.
7. Ability to work independently with minimal supervision and collaborate effectively within a team environment.
8. Commitment to maintaining confidentiality and protecting sensitive information in accordance with HIPAA and other privacy regulations.

Benefits:

• Competitive salary
• Provident Fund
• Paid time off and holidays
• Opportunities for professional development and growth

At XenMD, we are committed to fostering a diverse and inclusive workplace where all employees feel valued, respected, and empowered to contribute to our mission of providing exceptional healthcare services. We encourage individuals from underrepresented backgrounds to apply.

• If you are passionate about healthcare and thrive in a fast-paced, dynamic environment, we invite you to join our team as a Credentialing Specialist at XenMD. Apply today to be part of our dedicated team of healthcare professionals making a difference in the lives of patients and providers.