Credentialing Specialist

1 - 4 years

3 - 4 Lacs

Posted:2 months ago| Platform: Naukri logo

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Job Type

Full Time

Job Description

Dear All, Greetings from Flatworld Healthcare Services. WE ARE HIRING !! Job Title: Credentialing & Provider Enrollment Specialist Department: Revenue Cycle Management (RCM) Experience Required: 1 to 4 Years Location: Bangalore Employment Type: Full-time Interested candidates can share their CVs at pavan.v@finnastra.com or contact 9035473861 (Available between 12 AM - 9 PM ). Job Summary: We are seeking a detail-oriented and proactive Credentialing & Provider Enrollment Specialist with 12 years of experience in the healthcare RCM domain. The ideal candidate will be responsible for managing end-to-end provider credentialing, re-credentialing, and enrollment with insurance payers, ensuring compliance with regulatory standards and timelines. Key Responsibilities: Complete initial and re-credentialing applications for healthcare providers. Submit and track enrollment applications with Medicare, Medicaid, and commercial payers. Maintain and update provider information in internal databases and payer portals. Monitor expirables (licenses, certifications, etc.) and ensure timely renewals. Communicate with providers, payers, and internal teams to resolve enrollment issues. Ensure compliance with payer-specific and regulatory credentialing requirements. Follow up with insurance companies to check application status and resolve delays. Assist in audits and provide necessary documentation as required. Qualifications: Bachelors degree preferred (or equivalent experience in healthcare administration/RCM). 1 to 4 years of hands-on experience in provider credentialing and enrollment. Knowledge of payer requirements and CAQH, PECOS, NPPES, etc. Strong communication, organizational, and follow-up skills. Proficient in MS Office and credentialing software/tools. Preferred Skills: Experience working with U.S. healthcare providers. Familiarity with medical billing and insurance guidelines. Ability to manage multiple priorities in a deadline-driven environment. Perks & Benefits: 5 Days Working Provident Fund & Gratuity Medical Insurance Travel Allowance Fresher and non-relevant experience applicants, please ignore!

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Flatworld Solutions (FWS) logo
Flatworld Solutions (FWS)

IT Services and IT Consulting

Princeton New Jersey

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