Credentialing Specialist

Location: Chennai, India

Shift: Night Shift (US Healthcare Process)

Experience Required: 2–4 years in US Healthcare Credentialing

Department: Provider Enrollment & Credentialing

Reports To: Operations Head

About the Role

We are looking for a detail-oriented and proactive Credentialing Specialist to join our fast-growing Revenue Cycle Management team. The ideal candidate will be responsible for managing the end-to-end credentialing and re-credentialing process for healthcare providers, ensuring compliance with payer requirements, and maintaining up-to-date records to support timely enrollments and renewals.

Key Responsibilities

• Manage provider credentialing, re-credentialing, and enrollment with commercial and government payers (Medicare, Medicaid, BCBS, Aetna, Cigna, UHC, etc.).
• Complete and submit CAQH profiles, NPI applications, and payer enrollment forms accurately and within deadlines.
• Maintain an updated database of all provider information, including licenses, certifications, malpractice insurance, and expirables.
• Track and follow up with payers to ensure timely enrollment approvals and address any denials or rejections.
• Work closely with providers, practice managers, and internal teams to collect and verify credentialing documents.
• Update internal systems and communicate status reports to management and clients regularly.
• Ensure compliance with NCQA, CMS, and payer-specific guidelines.
• Assist in creating SOPs and process documentation to support scalability and efficiency.

Required Skills & Qualifications

• Bachelor’s degree or equivalent.
• 2–4 years of hands-on experience in US healthcare credentialing or enrollment.
• Strong understanding of CAQH, PECOS, NPPES, Availity, and payer portals.
• Excellent communication and follow-up skills (both verbal and written).
• Strong organizational skills and attention to detail.
• Proficiency in MS Excel, Word, and basic CRM or RCM software tools.
• Ability to work in a fast-paced environment with minimal supervision.

Growth Opportunities

As part of a rapidly expanding RCM organization, the Credentialing Specialist will have opportunities to:

• Lead small teams as the process scales.
• Cross-train in Provider Enrollment, Eligibility, and Payer Contracting.
• Participate in automation and process improvement initiatives.

Job Types: Full-time, Permanent

Pay: ₹17,052.86 - ₹45,131.84 per month

Benefits:

• Health insurance
• Paid sick time

Work Location: In person