Credentialing Specialist

Job Description

Job Summary We are seeking a highly organized and detail-oriented Credentialing Specialist with hands-on experience in Revenue Cycle Management (RCM) to join our growing healthcare operations team. The ideal candidate will manage end-to-end credentialing and re-credentialing processes while contributing to overall revenue cycle efficiency. Key Responsibilities Manage provider credentialing and re-credentialing applications for insurance payers, including Medicare and Medicaid. Follow up with insurance companies and regulatory bodies for application status and issue resolution. Maintain accurate and up-to-date provider data in CAQH and other relevant portals. Track and manage expirables (licenses, certifications, contracts) and maintain timely renewals. Collaborate with billing teams to ensure credentialing status aligns with claims submission requirements. Assist in the denial management process related to credentialing issues. Work closely with the RCM team to support eligibility, pre-authorization, and claim submission tasks. Generate and maintain reports regarding credentialing status, expirations, and timelines. Requirements Minimum 2 years of experience in provider credentialing and RCM processes. Strong knowledge of insurance payers’ credentialing requirements, including CAQH, NPI, PECOS. Familiarity with the U.S. healthcare system, medical billing cycles, and denial management. Excellent communication skills – verbal and written. Ability to multitask, prioritize and manage time effectively. Proficient in MS Office and credentialing software/tools. Attention to detail and strong organizational skills. Job Type: Full-time Pay: ₹20,000.00 - ₹50,000.00 per month Schedule: Night shift US shift Work Location: In person