Credentialing & Enrollment Representative

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Medusind Inc.

Role overview

Summary

This role is for a Credentialing & Enrollment Representative who evaluates and coordinates the credentialing and recredentialing processes for clinical providers and clinics. You will work under the Provider & Enrollment and Contracts Manager to ensure compliance with health insurance plans.

Qualifications

Experience in credentialing and enrollment processes.
Knowledge of health insurance plans.
Ability to analyze and evaluate provider applications.
Strong organizational skills.
Excellent communication skills.

Responsibilities

Evaluate credentialing processes for clinical providers and clinics.
Analyze applications for participation with health insurance plans.
Coordinate recredentialing processes for providers.
Assist in managing documentation related to provider enrollment.

Key facts

Remote from: California (USA), United States
Full time
Enrollment Advisor
English

Hard skills

About the company

Medusind Inc.

Outsourcing & BPO
XLarge
1,001–5,000

Medusind is a leading medical and dental billing and revenue cycle management company. We help organizations maximize revenue and reduce operating costs. Our highly trained team of experts brings deep expertise, 1:1 dedicated services and full transparency and data tracking. Our unique combination of powerful technology solutions and client-focused service significantly improves the efficiency and profitability of medical practices, hospitals, dental groups, GPOs and third-party administrators. Client satisfaction is the primary focus of the Medusind leadership and staff. Our detailed eye for processes, highly experienced personnel, cutting edge technology and forward thinking approach allows us to deliver effective solutions while staying ahead of healthcare industry changes. ➤ More than 3,000 dedicated employees including our physician-led coding team staffed by AAPC certified coders with expertise in CPT, ICD-10, HCPCS level II and DRG codes across various specialties. ➤ Leading edge technology including our MedClarity PM, PracticeGenie EMR and QuickVerify dental eligibility solution. ➤ 12 locations across the US and India - Miami, Orlando, Sarasota, Los Angeles, Fort Worth, Oklahoma City, Newark, Roanoke, Mumbai, Chennai, Ahmedabad, Coimbatore ➤ We provide services to more than 6,000 healthcare providers across all specialties ➤ ISO 27001 Certified and HIPAA compliant

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Job description

Position Overview:

Under the direction of the Provider & Enrollment and Contracts Manger, the Credentialing & Enrollment Representative evaluates, analyzes, and coordinates all aspects of the credentialing and recredentialing processes of clinical providers (Medical, Dental, Optometry and Behavior Health) and clinics with participating health insurance plans.