Should have working experience in US Healthcare Credentialing ProcessPayer and Provider Processes. Must have knowledge of Delegation Process.
Ensure credentialing processes are following professional standards bylaws state and federal regulatory requirements.
Verifying primary source data such as provider education board certifications licensure and other eligibilities /documents.
Work on experience in All modules of CAQH. Overall should be expertise with CAQH.
Ensuring timely credentialing and recredentialing of network providers and working with Internal/External Team to ensure credentialing files completed within timeframe and compliance.
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