Company : Human Xpert India Pvt. Ltd. Location :39,Chettinad Chambers(4th Floor Dr.Radha Krishnan Salai, 5th St, Mylapore, Chennai, Tamil Nadu 600004 India (Onsite / Hybrid / Remote – as applicable) Employment Type Full-time Job Summary Human Xpert India Pvt. Ltd. is seeking an experienced SME – Credentialing to manage and oversee end-to-end provider credentialing and re-credentialing processes. The ideal candidate will have strong domain expertise, ensure compliance with regulatory and payer requirements, and support process improvement and team guidance. Key Responsibilities Handle end-to-end provider credentialing and re-credentialing for physicians and allied healthcare providers Ensure compliance with NCQA, CMS, state, and payer-specific guidelines Review and verify provider documents including licenses, certifications, DEA, NPI, and malpractice insurance Coordinate with insurance payers, hospitals, and internal teams for timely credentialing approvals Maintain accurate and up-to-date credentialing records and databases Act as a subject matter expert for credentialing-related queries and escalations EFT , ERA and portal creation , provider data base management Conduct audits and quality checks to ensure adherence to SLAs and compliance standards Support training and mentoring of junior credentialing staff Identify process gaps and recommend improvements to enhance efficiency and accuracy Prepare reports and dashboards related to credentialing status and performance metrics Required Skills & Qualifications Bachelor’s degree in Life Sciences, Healthcare Administration, or a related field 1 –6+ years of experience in US healthcare credentialing Strong knowledge of provider enrollment and credentialing workflows Familiarity with NCQA, CAQH, CMS, and payer portals Excellent analytical, documentation, and communication skills Ability to handle complex cases and escalations independently Strong attention to detail and time-management skills Preferred Qualifications Prior experience as an SME or Team Lead in credentialing Experience working with US healthcare clients Exposure to audits and compliance reviews Certification in healthcare credentialing (if applicable) Key Competencies Subject matter expertise in credentialing Problem-solving and decision-making Quality and compliance orientation Team mentoring and collaboration Pay: From ₹30,000.00 per month Benefits: Food provided Paid sick time Provident Fund Work Location: In person Expected Start Date: 07/01/2026
Company : Human Xpert India Pvt. Ltd. Location :39,Chettinad Chambers(4th Floor Dr.Radha Krishnan Salai, 5th St, Mylapore, Chennai, Tamil Nadu 600004 India (Onsite / Hybrid / Remote – as applicable) Employment Type Full-time Job Summary Human Xpert India Pvt. Ltd. is seeking an experienced SME – Credentialing to manage and oversee end-to-end provider credentialing and re-credentialing processes. The ideal candidate will have strong domain expertise, ensure compliance with regulatory and payer requirements, and support process improvement and team guidance. Key Responsibilities Handle end-to-end provider credentialing and re-credentialing for physicians and allied healthcare providers Ensure compliance with NCQA, CMS, state, and payer-specific guidelines Review and verify provider documents including licenses, certifications, DEA, NPI, and malpractice insurance Coordinate with insurance payers, hospitals, and internal teams for timely credentialing approvals Maintain accurate and up-to-date credentialing records and databases Act as a subject matter expert for credentialing-related queries and escalations EFT , ERA and portal creation , provider data base management Conduct audits and quality checks to ensure adherence to SLAs and compliance standards Support training and mentoring of junior credentialing staff Identify process gaps and recommend improvements to enhance efficiency and accuracy Prepare reports and dashboards related to credentialing status and performance metrics Required Skills & Qualifications Bachelor’s degree in Life Sciences, Healthcare Administration, or a related field 1 –6+ years of experience in US healthcare credentialing Strong knowledge of provider enrollment and credentialing workflows Familiarity with NCQA, CAQH, CMS, and payer portals Excellent analytical, documentation, and communication skills Ability to handle complex cases and escalations independently Strong attention to detail and time-management skills Preferred Qualifications Prior experience as an SME or Team Lead in credentialing Experience working with US healthcare clients Exposure to audits and compliance reviews Certification in healthcare credentialing (if applicable) Key Competencies Subject matter expertise in credentialing Problem-solving and decision-making Quality and compliance orientation Team mentoring and collaboration Pay: From ₹30,000.00 per month Benefits: Food provided Paid sick time Provident Fund Work Location: In person Expected Start Date: 07/01/2026