Medical Billing Insurance credentialing

Company Description Prakruti Medsol LLP is a healthcare-focused organization specializing in medical billing and insurance-related services for clinics and hospitals. The company is committed to accurate, compliant, and efficient revenue cycle management, helping providers streamline operations and improve cash flow. Prakruti Medsol LLP emphasizes strong professional ethics, attention to detail, and collaboration with healthcare partners. Team members work in an environment that values learning, process improvement, and service quality.
Role Description This is a full-time, on-site role based in Ahmedabad for a Medical Billing Insurance Credentialing professional. The role involves handling insurance credentialing processes for healthcare providers, including preparing, submitting, and tracking applications with various insurance carriers and Medicare. Daily tasks include reviewing and updating provider information, verifying credentials, maintaining accurate records, and ensuring compliance with payer and regulatory requirements. The role also includes working with medical billing teams to address denials, clarify coverage issues, and support timely reimbursements. Collaboration with internal stakeholders and external insurance representatives, as well as clear communication with providers, is essential.
Qualifications
Strong understanding of Medical Terminology and ability to interpret clinical documentation accurately.
Knowledge of Denials management, including identifying causes and supporting resolution processes.
Working familiarity with ICD-10 coding principles relevant to billing and insurance claims.
Experience with Insurance processes, including commercial payers, and foundational knowledge of Medicare guidelines.
Attention to detail, strong organizational skills, and ability to manage multiple credentialing files simultaneously.
Proficiency in using medical billing or practice management software and standard office applications.
Effective written and verbal communication skills and ability to coordinate with providers, payers, and internal teams.
Prior experience in medical billing, insurance credentialing, or healthcare administration preferred.
Relevant diploma or degree in healthcare administration, billing, or a related field is beneficial.

Work arrangement
No