Credential Specialists

Managing provider data in CAQH and handling full credentialing and enrollment. Receiving requests from the practice and provider. Generating payer applications on behalf of providers to complete credentialing. Submitting documents to payers through the provider portal and using the CAQH portal to share provider information. Ensuring easy access to provider information for credentialing purposes. Maintaining the CAQH application up to date. Verifying provider documents such as: CV / Resume Educational documents State medical licenses DEA Board certifications Passport Driving license Liability insurance Tracking and maintaining re-credentialing dates and ensuring the security of all personnel and credentialing records. Ensuring compliance with regulatory requirements and timely submission of enrollment applications. Having familiarity with payers and their procedures for provider enrollment. Experience in calling, emailing, and sending faxes to payers to check the credential status of providers. Experience - 3 to 4 years Budget - 4.50 LPA - 5.20 LPA( Depends on Candidate Experience) Shift - Night Location - Coimbatore • Should have experience in complete Provider Credentialing process. • Should be familiar with the payor and their procedure to enroll provider. • Should have experience in completing Applications/Request/CAQH without any Errors. • Should have experience in Calling/Sending Emails/Sending Fax to payor for Credentialing Status of a Provider. • Meet compliance requirements like HIPAA etc. • Meet QMS and ISMS requirements. • Meet productivity and Quality Standards