Credentialing specialist Job Vacancy in Wow jobs Bengaluru, Karnataka – Updated today
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Company Name : Wow jobs
Location : Bengaluru, Karnataka
Position :
Job Description : Education, Skills & Experience: Required Experience:4+ Years’ Experience in Credentialing & RCMBachelor degree or equivalent.Ability to communicate effectively both orally and in writing.Customer service skills.Ability to respond to emails timely and effectively.Information research skills.Knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation.Working knowledge of clinical and/or hospital operations and procedures.Ability to use independent judgment and to manage and impart confidential information.Ability to maintain confidentiality and discretion in all communications on behalf of credentialing applicants and/or applications.Ability to make administrative/procedural decisions and judgements .Demonstrated advanced working knowledge of Microsoft Word and Excel.Ability to learn new applications to function effectively in a remote work environment.Skill in establishing priorities with independent coordination of day-to-day aspects.Advanced skills in computerized spread sheeting and database management.Job Description: Reviews and screens initial and reappointment credentialing applications for completeness, accuracy, and compliance with federal, state, local and University regulations, guidelines, policies, and standards.Conducts primary source verification, collects and validates documents to ensure accuracy of all credentialing elements; assesses completeness of information and qualifications relative to credentialing standards and Altus NorthStar Health System criteria.Identifies, analyzes and resolves extraordinary information, discrepancies, time gaps and other idiosyncrasies that could adversely impact ability to credential and enroll practitioners; discovers and conveys problems to CVO Credentialing Manager and entity Medical Staff Affairs for sound decision making in accordance with Medical Staff Bylaws, credentialing policies and procedures, federal, state, local and government/insurance agency regulations.Monitors files to ensure completeness and accuracy; reviews all file documentation for compliance with quality standards, accreditation requirements, and all other relevant policies; prepares and provides information to internal and external customers as appropriate.Enters, updates and maintains data from provider applications into credentialing database, focusing on accuracy and interpreting or adapting data to conform to defined data field uses, and in accordance with internal policies and procedures.Prepares, issues, electronically tracks and follows-up on appropriate verifications for efficient, high-volume processing of individual applications in accordance with applicable credentialing standards, established procedural guidelines, and strict timelines.Participates in the development and implementation of process improvements for the system-wide credentialing process; prepares reports and scoring required by regulatory and accrediting agencies, policies and standards.Communicates clearly with providers, their liaisons, entity Medical Staff Affairs. medical staff leadership and Administration, as needed to provide timely responses upon request on day-to-day credentialing and privileging issues as they arise.Job Types: Full-time, Regular / PermanentSalary: Up to ₹40,000.00 per monthBenefits:Work from homeSchedule:Fixed shiftSpeak with the employer+91-XXXXXXXXXX
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