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Credentialing Executive

Pro Global Private Limited Unverified

Islamabad , Pakistan

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Posted Sep 15, 2022 159 views

We are hiring for a Credentialing Executive

  • Good understanding of insurance procedures and guidelines
  • Reviewing claim accuracy prior to claiming Scrubbing and Submission
  • Analysis and resolution of denied claims/cases.
  • Identify and resolve billing issues 
  • Benefits / Eligibility, Medical Coding & Basic Demographic Verification 
  • Quality & AR Analyst, Denial management, AR Specialist, and AR Follow Up
  • Payment Postings, reimbursement & collection analysis, and reporting
  • To ensure quality, timelessness, and accuracy in the entire billing process
  • Develop and manage KPIs and dashboards for increasing client satisfaction, outcomes, and retention.
  • Standardization of processes and workflows for efficient and optimized delivery of service that meets customer expectations in a cost-effective manner.
  • Develop short and long-term business and delivery models that give insights and predictability into key cost contributors.

Requirements

  • 2 years prior experience in US Medical Credential
  • Minimum Bachelor’s Degree in Commerce/Finance/Arts/ Pharmacy/ Microbiology or related
  • Excellent English communication skills both verbal & written, spoken English in American pronunciation is desired
  • Good Command over Excel, word, and health industry-related software tools
  • Excellent Organizational, Analytical skills and ability to adapt to changing situations
  • Proven Knowledge of basic medical terminologies such as coding-ICD10, CPT & HCPC
  • Experienced in Managing the Overall Revenue Cycle
  • Knowledge about Data Conversion and EMR implementation
  • Knowledge about enrollment & credentialing and EDI & ERA/EFT setup

Skills

Credentialing Knowledge Analytical Skills

Job Details

Industry:
Services
Functional Area:
Operations
Total Positions:
1 Post
Job Shift:
Third Shift (Night)
Job Type:
Full Time/Permanent
Job Location:
Islamabad, Pakistan
Gender:
No Preference
Minimum Education:
Bachelors
Career Level:
Experienced Professional
Minimum Experience:
2 Years
Apply Before:
Oct 21, 2022
Posting Date:
Sep 15, 2022
Diversity Inclusion:
We value diversity of our employees. All qualified applicants will receive fair consideration without regard to genders or socio-economic backgrounds.

Pro Global Private Limited

Services · 11-50 employees - Islamabad
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