Credentialing Specialist

Position: Credentialing Specialist
Location: Ahmedabad, Gujarat
Job Type: Full-Time
Experience Required: Minimum 2 years in medical credentialing

About the Role

We are seeking a Credentialing Specialist to join our growing team. The ideal candidate will have at least 2 years of experience in provider credentialing and enrollment processes. This role is crucial in ensuring providers are properly credentialed with insurance payers and regulatory bodies to maintain compliance and support seamless revenue cycle management.

Key Responsibilities

• Manage the full-cycle credentialing process for healthcare providers, including initial credentialing, re-credentialing, and ongoing updates.
• Verify provider information such as licenses, certifications, NPI, DEA, CAQH, and malpractice insurance.
• Submit and track applications with commercial insurance payers, Medicare, and Medicaid.
• Maintain accurate and up-to-date records in credentialing databases and systems.
• Ensure compliance with HIPAA, CMS, and state/federal regulations.
• Communicate with providers, insurance companies, and internal teams to resolve any credentialing issues.
• Monitor credentialing timelines and follow up proactively to avoid lapses or delays.
• Prepare reports and maintain documentation for audits and compliance reviews.

Required Qualifications

• Minimum 2 years of experience in healthcare credentialing.
• Strong understanding of CAQH, NPI, Medicare, Medicaid, and commercial payer processes.
• Knowledge of healthcare compliance regulations and standards (HIPAA, CMS, etc.).
• Excellent attention to detail and strong organizational skills.
• Ability to handle multiple applications and deadlines simultaneously.
• Proficiency in credentialing software, MS Office Suite, and databases.
• Strong communication and interpersonal skills.

What We Offer

• Competitive salary package.
• Growth and career advancement opportunities.
• Supportive and collaborative work environment.
• Training and certification reimbursement options.
• Pick and drop facility only for Female candidates.

How to Apply

Interested candidates can send their updated resume to rcmadmin@mediproxx.com with the subject line: “Application – Credentialing Specialist.”

Job Type: Full-time

Benefits:

• Food provided
• Health insurance
• Leave encashment

Work Location: In person