Nexel Services (pvt) Ltd
Tuesday 18, Aug 2020

Credentialing/Provider Enrollment Specialist 

Nexel Services (pvt) Ltd

Rawalpindi/Islamabad, - Pakistan - 30k to 80k (PKR) - Per Month

2 Years Night Shift Full-Time

Expired

Job Details

Category:
Health Care Provider
Career Level:
Experienced (Non-Managerial)
Experience:
2 Years
Required Qualification:
Bachelor's
Requires Traveling:
No
Salary:
30000 - 80000 PKR
Salary Type:
Per Month
Total Vacancies:
2
Skills
healthcarecompliancestandardscredentialingdocumentsprocesslicenseinsuranceenrollmentscheduletimeproviderworkflowdatabaseprocessinghealthabstractingdataapplicationclaimstrackingprovidingclaims processingprimarysourceverificationgeneralcorrespondencesubject matter expertinternalconsultantcoachmentorassociatedomaincomputer proficiencymicrosoftofficewordexcelpowermedicalinterpersonal skillscustomer service orientationstrong analytical skills

Description

This position verifies the credentials of healthcare providers are in compliance with state and federal standards, communicates with physicians and clients to obtain credentialing documents, receive/process all initial credentialing/re-credentialing applications and manage license, insurance, and DEA expiration for providers including their Enrollment with all payers.

Description
Job Schedule: Full Time
Job Shift: Night
Job Description:
We are looking for a candidate who can
• Carry out the provider enrollment function as delegated by Payer plans.
• Complete accurate and timely payer enrollments applications and coordinates workflow for applications in the queue,
• Maintain the Provider Enrollment database.
• Provide guidance to Providers on their enrollment, and on CAQH database updates.
• Processing provider applications to all health plans. Abstracting pertinent data from the Universal application and completing payer specific enrollment documents to assure claims acceptance.
• Processing and tracking of applications to ensure timely enrollment, and providing RCMG Department with provider ID numbers for claims processing.
• Secure documents for primary source verification.
• Produce and reply to general correspondence.
• Assure revalidation of providers with various payers in a timely manner.
• Subject Matter Expert and Internal consultant on provider enrollment. Collaborates with various departments and functions affected by the enrollment process Coach and mentor the Credentialing Associate.
Qualifications
• Graduation Degree
• - years’ experience in similar domain with responsibilities related to credentialing and provider enrollment
• Understanding of the credentialing and privileging process for health plans
• Computer Proficiency
• Microsoft Office to include Word, Excel, Power Point, PDF
• Working knowledge of medical terminology
• Excellent interpersonal skills
• Customer service orientation
• Ability to work well within a team structure.
• Attention to detail
• Ability to work with multiple projects and deadlines
• Strong analytical skills
• Knowledge of delegated credentialing requirements

Job Specification

Nexel Services (pvt) Ltd is in search of talented and motivated individuals for the post of Credentialing/Provider Enrollment Specialist in the field of Health Care Provider in one of their office located in Rawalpindi/Islamabad - Pakistan. The ideal candidate should have bachelor's qualification and atleast 2 years of experience. The position require healthcare, compliance, standards, credentialing, documents, process, license, insurance, enrollment, schedule, time, provider, workflow, database, processing, health, abstracting, data, application, claims, tracking, providing, claims processing, primary, source, verification, general, correspondence, subject matter expert, internal, consultant, coach, mentor, associate, domain, computer proficiency, microsoft, office, word, excel, power, medical, interpersonal skills, customer service orientation, strong analytical skills mandatory skills. This is a Full-Time night shift job.Salary vary between 30k to 80k (PKR) per month depending upon skills and years of experience candidate got.


About Nexel Services (pvt) Ltd

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