Mohan Ram

To enhance my professional skills, capabilities and knowledge in an organization which recognizes the value of hard work and trusts me with responsibilities and challenges.

Credentialing Team coordinator - Lincoln reimbursement solutions

(2024-01)

Credentialing Team coordinator - ORCHESTRAEHR SOLUTIONS PVT LTD - Madurai

(2019-05 - 2024-01)

• Manage end-to-end provider credentialing and payer enrollment for US healthcare providers
• Prepare, submit, and track enrollment applications with commercial and government payers
• Handle new provider enrollment, re-credentialing, revalidation, group enrollment, and provider updates
• Complete payer-specific enrollment forms accurately
• Coordinate with providers, clients, and internal teams to collect required documents
• Track application status and follow up with payers until approval/completion
• Create, update, attest, and maintain CAQH / CAQH ProView profiles
• Ensure provider details are accurate and up to date across all systems
• Maintain NPI, taxonomy, license, DEA, malpractice insurance, board certification, W-9, and provider demographic information
• Monitor expiration dates for licenses, certifications, malpractice coverage, and other credentials
• Work with commercial payers such as Aetna, Cigna, UnitedHealthcare, Humana, BCBS, Medicare Advantage plans, Medicaid MCOs, and regional payers
• Support Medicare and Medicaid enrollment/revalidation processes where applicable
• Manage individual provider and group practice enrollment
• Handle payer portal registrations, EFT/ERA enrollments, and demographic updates
• Resolve enrollment issues, application rejections, missing information requests, and payer delays
• Maintain accurate credentialing records and tracking sheets
• Review provider documents for completeness and compliance
• Prepare credentialing packets and maintain audit-ready documentation
• Track effective dates, approval dates, participation status, payer IDs, and enrollment status
• Ensure all credentialing data is organized and easily accessible
• Follow up with insurance payers through calls, emails, portals, and fax as required
• Communicate credentialing status updates to management and clients
• Escalate delays, missing documents, payer issues, and enrollment problems on time
• Coordinate with billing teams to ensure providers are enrolled before claim submission

Sales Co-Ordinator - SACS POWER PVT LTD - Madurai

(2014-10 - 2015-01)

• Promote client development
• Checking of sales enquiry
• Prepared Quotation
• Prepared dispatch schedule plan with transport
• Maintenance of purchase record regarding
• Verified sales and collection bill payment
• Develop & Maintain good seller-buyer relationship
• Clear of buyer issuing enquires
• Content product seminar and demo

MBA - General - Annamalai University (2021)

B.E - Electrical & Electronics Engineering - P T R College of Engineering & Technology (2013)

D.E.E.E - Electrical & Electronics Engineering - Thanapandiyan Polytechnic College (2010)

High School - Sourastra HR. Sec school (2007)