Credentialing Specialist

Job Description:

We are seeking a detail-oriented and proactive Credentialing Analyst to manage the end-to-end credentialing process for healthcare providers. This role involves timely onboarding, payor credentialing, documentation, and compliance tracking to ensure all providers meet regulatory and client requirements.

Key Responsibilities:

• Respond promptly to credentialing-related emails and follow-ups within 24 hours.
• Manage onboarding of new providers, including welcome communication, documentation, and source verification.
• Handle Collaborative Agreements and update provider records in systems like Athena and CredentialMyDoc (CMD).
• Submit and track payor applications and rosters; ensure follow-ups with payors.
• Allocate and prioritize tasks via CMD based on daily workload.
• Maintain and update CAQH profiles every 120 days for active providers.
• Conduct monthly OIG verifications and ensure compliance with client requirements.
• Prepare regular reports on credentialing holds, provider onboarding status, and facility credentialing by payor.
• Participate in weekly calls with internal stakeholders and clients.
• Maintain and update SOPs related to credentialing.

Requirements:

• Prior experience in healthcare credentialing or provider onboarding preferred.
• Strong attention to detail, communication, and time management skills.
• Excellent communication skills in English, both written and verbal.
• Strong attention to detail, organization, and time management.
• Familiarity with systems like Athena, CMD, and CAQH is an advantage.
• Strong expertise in Medicare, Medicaid and CAQH Portal
• Also has good knowledge of PSV & Collaborative agreements

Qualification:

• Graduation in any stream.
• Prior experience in healthcare credentialing or provider onboarding is preferred.

Job Types: Full-time, Permanent

Benefits:

• Health insurance
• Leave encashment
• Paid time off
• Provident Fund

Work Location: In person