Credentialing Executive

Job Description

• Manage credentialing for healthcare providers, ensuring accurate and timely processing.
• Verify provider credentials, licenses, and certifications for compliance.
• Coordinate with insurance companies to enroll providers and resolve enrollment issues.
• Maintain and update provider information in the RCM system.
• Monitor enrollment statuses and track changes in insurance plans and regulations.
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.
• Should have excellent knowledge in Group Medicare and Medicaid Enrollment/Contracts along with commercial insurances.
  
  

• Bachelor’s degree in any discipline.
• Minimum of 1 to 3 years of experience working in healthcare credentialing, preferably in a medical billing or revenue cycle management setting.
• Manage all aspects of the provider enrollment and credentialing process, including initial applications, re-credentialing and maintaining provider information in all necessary systems.
• Excellent communication in English, both written and oral.
• Willing to work the night shift (any 9 hrs. between 6:30 pm 3:30 am)
• Salary: as per company policy