Company Overview

Total RCM Solutions, LLC, incorporated on the 13th of June 2018, is a reputed revenue cycle management company that provides services to healthcare providers across the United States of America. Our team of professionals, with over 100 years of combined expertise, are skilled in various EMR, PM systems, and specialties, making Total RCM Solutions a trusted partner for a range of end-to-end RCM services, back office support, appeal management, claim reviews, and patient services solutions.

Job Overview

We are seeking a dynamic and detail-oriented Credentialing Specialist to join our team in Bangalore. This is a full-time, remote position suitable for a mid-level professional with extensive experience in the credentialing process within the healthcare industry.

Qualifications and Skills

• Excellent organizational skills to manage and maintain credentialing records and documentation.
• Strong communication skills for effective interaction with healthcare providers, payers, and internal teams.
• Analytical skills to assess and verify credentialing information and ensure compliance with standards.
• Problem-solving skills to address and resolve any issues related to credentialing processes.
• Computer proficiency to efficiently use various credentialing software and systems.
• Attention to detail (Mandatory skill) to meticulously handle credentialing documents and processes.
• In-depth knowledge of the credentialing process (Mandatory skill) to facilitate smooth and accurate credentialing for healthcare providers.
• Effective time management (Mandatory skill) to prioritize tasks and meet credentialing deadlines.

Roles and Responsibilities

• Manage the credentialing process for healthcare providers, ensuring all documentation and information are accurate and up-to-date.
• Coordinate with healthcare providers and payers to gather required information and complete credentialing applications.
• Maintain and update credentialing records, databases, and files to ensure compliance with industry standards and regulations.
• Monitor and track credentialing status and follow up on outstanding items to ensure timely completion.
• Communicate effectively with internal teams, healthcare providers, and payers to address any credentialing-related inquiries or issues.
• Conduct regular audits of credentialing files to ensure ongoing compliance with regulatory requirements.
• Assist in the development and implementation of credentialing policies and procedures to improve efficiency and accuracy.
• Stay informed on the latest industry trends and regulatory changes to ensure compliance and best practices in credentialing.