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Credentialing Executive

Experience : 1+ year in medical billing service providers

Primary Duties and Responsibilities

✓  Collect all the data and documents required for filing credentialing applications from the physicians
✓  Store the documents centrally on our secure document management systems
✓  Understand the top payers to which the practice sends claim and initiate contact with the payers
✓  Apply the payer-specific formats after a due audit
✓  Timely follow-up with the payer to track application status
✓  Obtain the enrolment number from the payer and communicate the state of the application to the physician
✓  Periodic updates of the document library for credentialing purposes

Skill Sets

✓  Should have worked as a Credentialing Analyst for at least 1-year medical billing service providers.
✓  Good Knowledge in Provider credentialing (Doctor’s side).
✓  Experience in Insurance calling.
✓  Good knowledge in filling insurance enrolment applications.
✓  Good experience in CAQH, PECOS applications.
✓  Experience in Medicare, Medicaid, Commercial insurance enrolment.

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