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    Credentialing Specialist" - Ahmedabad - Aqkode Healthcare Services & Solutions

    Aqkode Healthcare Services & Solutions
    Aqkode Healthcare Services & Solutions Ahmedabad

    2 weeks ago

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    Healthcare
    Description

    Job Summary


    We are seeking a highly skilled and detail-oriented individual to join our team as a Provider Enrollment Specialist. The ideal candidate will have a minimum of 6 months to 1 year of experience in healthcare administration, excellent communication skills, and a strong understanding of Microsoft Office.



    Key Responsibilities



    • Prioritize and Manage Provider Enrollments: Set up and maintain CAQH/PECOS profiles, complete provider enrollments with Medicare and private payers, and establish ERA and EFT enrollments.

    • Optimize Reimbursement Performance: Maintain accurate provider-payer data, verify credentials, and provide timely updates on panel availability.

    • Streamline Enrollment Process: Develop quality assurance processes, perform appeals for closed panels, and ensure seamless enrollment submissions.

    • Coordinate Out-of-Network Enrollments: Complete NPI registrations and follow up on application status for providers outside the network.

    • Maintain Confidentiality and Adhere to HIPAA Guidelines: Ensure the highest level of confidentiality and comply with all relevant regulations.



    Requirements



    • Minimum 6 months to 1 year of experience in healthcare administration

    • Excellent written and verbal communication skills

    • Working knowledge of Microsoft Office basics

    • Prioritization and multi-tasking skills

    • Ability to maintain strict confidentiality and adhere to HIPAA guidelines


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Ahmedabad