BHAWNA KADAM
Kota
Summary
Experienced Provider Licensing Analyst with a strong background in healthcare administration, specializing in provider licensure, credentialing, and enrollment. Adept at handling multi-state licensing processes, maintaining compliance with regulatory standards, and managing provider data with accuracy and efficiency. Proficient in tools such as Microsoft Excel, Outlook, Word, and credentialing platforms like CAQH and PECOS. Recognized for strong organizational skills, attention to detail, and the ability to manage high volumes of work in fast-paced environments.
Overview
7
7
years of professional experience
Work History
Provider Licensing Analyst
Medtigo India
Pune
06.2023 - 06.2025
- Review and verify application documents for completeness and compliance with state board and federal regulations.
- Collect, organize, and process required credentials, including medical degrees, residency/fellowship certificates, board certifications, and continuing education records.
- Coordinate with providers (MD, DO, RN, APRN) to obtain missing or updated information.
- Submit applications to state licensing boards; track submission dates and confirmations.
- Follow up with state boards, agencies, and regulatory bodies to monitor application status and resolve delays.
- Verify professional history, including employment, training programs, and malpractice records.
- Conduct primary source verification for education, training, licensure, and certifications.
- Maintain accurate records in internal credentialing/licensing databases.
- Ensure compliance with state-specific laws, renewal requirements, and continuing education mandates.
- Communicate regularly with providers, HR teams, and credentialing staff regarding application progress.
- Prepare and process renewal applications to ensure licenses remain active and in good standing.
- CTC - 5.5LPA
Credentialing Specialist
Crystal Voxx, LTD
Ahmedabad
09.2019 - 06.2023
- Coordinated the credentialing and enrollment process for healthcare providers
- Scheduled and managed patient appointments for follow-up care, ensuring timely and efficient service delivery
- Enrolled and credentialed specialists and physicians with various healthcare insurance programs, including Medicare, Medicaid, and UHC
- Demonstrated discretion and professionalism when handling sensitive information
- Utilized NPPES site for provider registration and managed CAQH profiles
Patient Care Pharmacist
Kloudscript Kyte Consulting LLP
Ahmedabad
10.2018 - 06.2019
- Performed online prior authorization ‘PA’ and submitted clinical notes of patients to insurance for approval
- Followed up with healthcare insurance weekly for status updates on prior authorization applications
- Conducted clinical writing for specialty medication
- Provided support to healthcare professionals and patients, involving receipt and tracking of medical inquiries
- Handled adverse event and product quality complaints and other types of calls as required
Education
B.Pharmacy -
Swami Vivekananda College Of Pharmacy
Indore, MP05.2018
Skills
- Provider licensing
- Provider enrollment
- CAQH
- NPPES
- Strong communication
- Microsoft Excel
- MS office
Websites
Timeline
Provider Licensing Analyst
Medtigo India
06.2023 - 06.2025
Credentialing Specialist
Crystal Voxx, LTD
09.2019 - 06.2023
Patient Care Pharmacist
Kloudscript Kyte Consulting LLP
10.2018 - 06.2019
B.Pharmacy -
Swami Vivekananda College Of Pharmacy
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