Nethaji Manoharan

Open and inclusive collaborator with strong team-building skills. Excels at root cause analysis and dispute resolution. Leads by example to create positive and supportive working environments. Highly experienced in end-to-end provider/facility credentialing and enrollment processes, dedicated to driving efficiency and compliance.

Credentialing Team Lead at Ventra Health (2023-07 – Present)

• Leading a high-performing credentialing team, overseeing all aspects of the credentialing lifecycle to ensure compliance and timely provider onboarding.
• Directly collaborate with onshore team and facility/payer expedite complex credentialing and contracting issues, minimizing revenue cycle delays.
• Coordinated training sessions for new colleague.
• Monitored team performance and provided constructive feedback.
• Utilize specialized industry portals (e.g., CAQH, PECOS, NPPES) to manage and maintain accurate provider data and submissions.

Sr. Credentialing Specialist at Sai Systems Health Tech Pvt. Ltd (2021-05 – 2022-05)

• Worked within a specialized team to maintain provider/facility profiles for over a thousand healthcare providers, as well as new enrollments.
• Established new guidelines and procedures to maximize workflow and communication, directly increasing team efficiency, output, and quality of service.
• Assisted in managing accounts by maintaining client relations and performing routine checks and audits.
• Utilized credentialing software to track application statuses and deadlines.
• Processed re-credentialing applications for existing providers according to contractual requirements.

Sr. Executive at E-care India Pvt. Ltd (2019-01 – 2020-12)

• Maintained accurate records regarding all aspects of the enrollment process in a secure database.
• Created enrollment records in the Provider Enrollment Chain Organization System (PECOS) and maintained CAQH records.
• Maintained frequent contact with providers and practice managers to verify and obtain outstanding credentialing information including Malpractice insurance policies, State Licenses, DEA certificates.
• Coordinated with internal teams to resolve enrollment discrepancies efficiently.
• Processed re-enrolment requests for terminated providers who wish to be reinstated into the network.
• Follow up with insurance carriers to address and rectify denied claims.

Sr. Client Partner at Access Healthcare Pvt. Ltd (2015-11 – 2019-01)

• Responsible for coordinating, monitoring, and maintaining the credentialing and re-credentialing process with accuracy and integrity of the credentialing database system.
• Compiled and maintained current and accurate data for all providers using CAQH applications.
• Completed provider credentialing and re-credentialing applications; monitored applications and followed up as needed.
• Tracked license and certification expirations for all providers to ensure timely renewals.

Bachelor of Computer Applications – Jaya College, Chennai (2012-06 – 2015-04)

Schooling (HSC/SSLC) – GBHS School, Podatur Pet (2008-06 – 2012-04)