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Hiring AR Hospital Billing Credential and Enrollment Specialist

  • AB7Solutions
  • Mohali, Punjab, India
  • Jul 15, 2020
Full time Health Care

Job Description

An A/R representative is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The representative will manage their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered. 

 

  1. Graduate with 1-5 years’ experience in US health care industry (HB or PB – HB preferred).
  2. Ability to read and interpret insurance explanation of benefits (EOBs
  1. Knowledge of payer edits, rejections, rules, and how to appropriately respond to each.
  2. Accuracy in identifying the cause of rejections/denials and selecting the most appropriate method for resolution.

Process - Credentialing 

Designation: Credentialing and Enrollment Specialist

Office Location - Mohali 

Experience Required - 2 - 4 years

Salary Range - 2,50,000 - 6,00,000 PA 

About AB7Solutions

Process - Credentialing 

Designation: Credentialing and Enrollment Specialist

Office Location - Mohali 

Experience Required - 2 - 4 years

Salary Range - 2,50,000 - 6,00,000 PA 

 

Position Description - Can collect all the data and documents required for filing credentialing applications from the physicians.

 

Primary Responsibilities:-

  • Maintain current and accurate data for all providers. 
  • Complete provider credentialing and credentialing applications; monitors applications and follows-up as needed.
  • Maintains copies of current state licenses, DEA certificates, malpractice coverage and any other required credentialing documents for all providers.
  • Maintains corporate provider contract files. 
  • Maintains knowledge of current health plan and agency requirements for credentialing providers.
  • Sets up and maintains provider information in online credentialing databases and systems.
  • Tracks license and certification expirations for all providers to ensure timely renewals.
  • Sets up and maintains provider information in online credentialing databases and systems. 
  • Tracks license and certification expirations for all providers to ensure timely renewals.
  • Ensures practice addresses are current with health plans, agencies, and other entities. 
  • Processes applications for appointment and reappointment of privileges to The Doctors Clinic (ASC).
  • Processes applications for appointment and reappointment of privileges to The Doctors Clinic (ASC). 
  • Maintains ASC appointment files, and information in the credentialing database. 
  • Store the documents centrally on our secure document management systems 
  • Obtain the enrolment number from the payer and communicate the state of the application to the physician 
  • Obtain the enrolment number from the payer and communicate the state of the application to the physician , 
  • Periodic update of the document library for credentialing purposes.  
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