Credentialing Specialist(Provider Side)

Credentialing Specialist(Provider Side)

Credentialing Specialist(Provider Side)

• Job Role: Credentialing Enrollment(Provider Side)

• Designation: Credentialing Specialist

• Qualification: Any UG & PG Degree/Diploma

• Exp:1-4 Years

• Location: Okkiyampettai ,Thoripakkam, Chennai

• Shift timings: Mid Shift (12:00 pm - 9:00 pm)

• Working Days: Monday to Friday

Key Responsibilities:

• Submit and track credentialing applications to insurance carriers and other healthcare payers.
• Maintain accurate provider records and update information with insurance companies, including NPI, malpractice, and licensure data.
• Communicate with insurance companies over the call and e-mails to resolve any issues or discrepancies in provider credentials.
• Verify the accuracy and completeness of documentation submitted for credentialing and re-credentialing.
• Ensure timely renewal of provider contracts with insurance companies and government payers (e.g., Medicare, Medicaid).
• Act as a liaison between healthcare providers, insurance carriers, and internal teams to resolve credentialing issues.
• Monitor and manage credentialing status for providers to ensure continued participation in insurance networks.
• Ensure compliance with regulatory requirements for insurance credentialing and maintain current knowledge of industry best practices.
• Maintain and update credentialing databases and systems.
• Prepare reports on credentialing activities and status for management.

Qualifications:

• 1-3 years of experience in insurance Credentialing (Provider Side) or healthcare administration.

• Strong knowledge of insurance credentialing processes, including experience with Medicare, Medicaid, and commercial insurance plans.
• Familiarity with the CAQH and National Provider Identifier (NPI) system, and related healthcare regulations.
• No cab facility is provided, Candidates are required to arrange their own transportation.

Interested candidates please contact HR- 7200153996

(Interview days- Monday to Friday)