Niranjan Sharnappa Dasari

About Niranjan Sharnappa Dasari

Honesty, Friendly and Funny Character.

Experience

1. Senior Group Leader

   Access Healthcare

   Apr 2025 — Present · Pune, IN

   The Provider Credentialing Senior Group Leader plays a vital leadership role in ensuring that healthcare providers are properly credentialed and enrolled with insurance payers, so that medical billing and reimbursement processes run smoothly.Sub Process :1) NPI (National Provider Identifier)2) Medical license3) DEA registration4) Board certifications5) Malpractice insurance6) CV and work history7) Tax ID (EIN or SSN)Role of a Provider Credentialing Senior Group Leader1. Leadership & Oversight* Lead and manage the credentialing Team & Team Leaders (Specialists, Coordinators, Clients).* Assign tasks, monitor productivity, and ensure timely completion of credentialing files.* Provide training and guidance on best practices, payer requirements, and regulatory changes.2. Credentialing Process Management* Oversee the entire credentialing lifecycle: initial credentialing, re-credentialing, and revalidations.* Ensure that provider applications are complete, accurate, and submitted on time.* Monitor deadlines and expirations for licenses, certifications, and recredentialing dates.3. Compliance & Quality Control* Ensure compliance with payer standards, NCQA, CMS, and state-specific regulations.* Audit credentialing files to ensure accuracy and completeness.4. Communication & Coordination* Serve as the liaison between providers, insurance companies, and internal departments.* Coordinate with providers to collect necessary documents and follow up on missing items.* Resolve complex credentialing issues and escalate to higher management if needed.5. Data Management & Reporting* Maintain accurate records in credentialing databases (e.g, CAQH, internal systems).* Generate reports on credentialing status, productivity, upcoming renewals, and expirations.6. Process Improvement* Identify process bottlenecks and recommend improvements to reduce turnaround time.* Stay updated on industry changes and adapt internal processes accordingly.