Credentialing Specialist

Job Description

Role: Credentialing Specialist (Provider Enrollment) Credentials Location: Pune, Maharashtra Type : Permanent Profile Overview: Graduate with 1-5 years Experience of Credentialing. Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases. Keep track of expiration dates for state DEA licenses, board certifications, and malpractice insurance for individual providers. Key Responsibilities: Maintain individual provider files with up-to-date information for governmental and commercial payer credentialing applications. Track contracted Managed Care Organizations, commercial payers, CMS Medicare, Medicaid, PECOS, NPPES, and CAQH to ensure all portal logins are active and accessible. Collaborate with providers to ensure timely updates to their CAQH database files as per CMS Medicare/Medicaid and Managed Care Organizations regulations. Coordinate, monitor, and maintain the credentialing, re-credentialing, and contracting processes with insurance companies. If interested, please share your updated resume along with the following details:- Total relevant experience in Credentialing: Current Salary: Expected Salary: Notice Period: