Credentialing Executive

Job Title: Credentialing Executive
Location: Hyderabad, Telangana
Company: Harmony United Medsolutions Pvt. Ltd.

About Us:
Harmony United Medsolutions Pvt. Ltd. [HUMS] is a dynamic and innovative company dedicated to revolutionizing the Healthcare Industry. We at HUMS take pride in being a reliable partner as a Healthcare Management Company. With nine years of experience, we have perfected our end-to-end services in medical billing, A.R. management, and other essential healthcare facets. We provide our services to Harmony United Psychiatric Care, a US-based Healthcare Company. We pride ourselves on our commitment to excellence, creativity, and pushing the boundaries of what's possible. As we continue to grow, we seek a talented candidate to join our team and contribute to our exciting projects.

Position Overview:
The Credentialing Executive will be responsible for managing the credentialing and re-credentialing processes for psychiatric care providers within our network. The role will also focus on maintaining up-to-date provider documentation, ensuring compliance with insurance companies, and monitoring provider licensing. This position requires a detail-oriented and proactive individual to ensure the smooth integration of providers into the insurance network and their continued compliance.

Responsibilities:

• Assist in the enrollment of providers with insurance companies, ensuring all required documentation is submitted timely and accurately.
• Collect, verify, and maintain the necessary documentation for all providers, ensuring compliance with regulatory standards and insurance requirements.
• Proactively follow up with insurance companies to track the status of credentialing applications, resolve issues, and ensure providers are credentialed in a timely manner.
• Coordinate and manage the re-credentialing process for existing providers, ensuring timely submissions and compliance with insurance companies’ requirements.
• Monitor and maintain CAQH (Council for Affordable Quality Healthcare) profiles for all providers, ensuring accuracy and compliance with industry standards.
• Oversee the process of enrolling providers with Medicare, ensuring compliance with all relevant regulations and ensuring successful enrollment.

Requirements:

• Minimum of 5 years of experience in healthcare credentialing or provider relations, preferably in US healthcare sector.
• Candidate must have a bachelor’s degree in any field.
• Experience with insurance portals, CAQH, and Medicare enrollment systems
• Excellent communication and interpersonal skills, with the ability to build rapport and trust at all levels of the organization.
• In-depth knowledge of credentialing processes, insurance company contracting, and regulatory requirements in the healthcare sector.
• Strong organizational and time management skills, with the ability to handle multiple tasks and deadlines.
• Ability to maintain confidentiality and work with sensitive provider data in a HIPAA-compliant manner.

Diversity, equality, and inclusion
Diversity, equality, and inclusion are fundamental to our success at HUMS. We actively promote diversity across all aspects of our organization, including but not limited to gender, race, ethnicity, sexual orientation, religion, disability, and age. We strive to foster an inclusive culture where diverse perspectives are embraced and everyone has equal opportunities to grow, contribute, and succeed.

Benefits:

• Competitive salary (including EPF and PS)
• Health insurance
• Four days’ workweek (Monday – Thursday)
• Opportunities for career growth and professional development
• Additional benefits like food and cab-drop are available

Please submit your resume and cover letter detailing your relevant experience and why you fit this role perfectly. We look forward to hearing from you!
In case of any queries, please feel to reach out us at [email protected]

Note: Available to take calls between 4:45 PM to 3:45 AM IST only from Monday to Thursday.

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