Credentialing and Enrolment specialist

Job Title:

Credentialing and Enrollment Specialist

Location:

Mumbai

Job Type:

Full-time

About the Role:

We are seeking a detail-oriented and organized Credentialing and Enrollment Specialist to join our team. This role is essential for ensuring that our providers are properly credentialed and enrolled with payers and networks to guarantee uninterrupted service delivery and reimbursement.

Key Responsibilities:

• Complete and maintain payer enrollment applications and credentialing processes for new and existing providers.
• Review, verify, and update provider information in internal systems and payer portals.
• Track application status and follow up with payers and providers to ensure timely completion.
• Monitor expiring documents, licenses, certifications, and re-credentialing requirements.
• Work collaboratively with internal departments, providers, and external payers to resolve issues.
• Maintain accurate, up-to-date records and credentialing files.
• Assist with delegated credentialing audits and ensure compliance with NCQA, URAC, CMS, and state requirements.
• Prepare reports and communicate credentialing/enrollment status to leadership and stakeholders.

Qualifications:

• High school diploma or equivalent required; associate or bachelor’s degree preferred.
• 1–3 years of experience in healthcare credentialing, enrollment, or provider data management.
• Familiarity with CAQH, PECOS, NPPES, payer portals, and credentialing software.
• Strong organizational skills and attention to detail.
• Excellent written and verbal communication skills.
• Ability to manage multiple priorities and meet deadlines in a fast-paced environment.

Preferred:

• CPCS or CPMSM certification from NAMSS.
• Experience working with Medicare, Medicaid, and commercial payers.

Job Types: Full-time, Permanent

Pay: ₹40,000.00 - ₹60,000.00 per month

Benefits:

• Food provided
• Paid sick time
• Paid time off

Schedule:

• Monday to Friday
• Night shift
• US shift

Supplemental Pay:

• Yearly bonus

Ability to commute/relocate:

• Mumbai, Maharashtra: Reliably commute or planning to relocate before starting work (Preferred)

Work Location: In person