12 Provider Credentialing Jobs

The ideal candidate for this position should possess excellent communication skills and have prior experience working as a Credentialing Analyst in medical billing service providers. A strong understanding of Provider credentialing and clearing house setup is required. Familiarity with Electronic Data Interchange (EDI), Electronic Remittance Advice Setup (ERA), and establishing Insurance Portals (EFT) is essential. The candidate should also have experience in Insurance calling, filling insurance enrollment applications, and be well-versed in CAQH and PECOS application processes. Knowledge of Medicare, Medicaid, and Commercial insurance enrollment is a plus. A positive attitude towards problem-solving and the ability to generate aging reports are important qualities for this role. Immediate joiners are preferred, and candidates must be flexible with shift timings. The location of the job is in Mohali, with 2-4 years of experience required. The salary offered is competitive and the company provides in-house meal facilities, cab facilities, and performance-based incentives. The work schedule involves any 5 days in a week, based on the process requirements.,

Job Summary The Provider Credentialing Specialist is responsible for end-to-end management of credentialing and re-credentialing of healthcare professionals and facilities. This includes verifying education, training, licensure, board certification, work history, malpractice history, and other professional qualifications in alignment with NCQA, URAC, and CMS standards. Key Responsibilities Collect, verify, and update provider data from various sources (CAQH, state boards, DEA, NPDB, OIG, etc.). Initiate credentialing and re-credentialing processes according to regulatory and client timelines. Evaluate credentialing applications for accuracy, completeness, and compliance with credentialing criteria. Liaise with providers, internal teams, and third-party verifiers for timely document submission and clarifications. Maintain and audit provider records in credentialing platforms (e.g., Cactus, Echo, HealthLine, Medversant). Generate and review primary source verifications (PSVs), sanction checks, and background verifications. Prepare credentialing files for committee review and credentialing decisions. Track and manage expirables (licenses, certifications, malpractice insurance) and send timely notifications. Ensure compliance with HIPAA , CMS , NCQA , URAC , and other accreditation standards. Support reporting, audit requests, and data submissions to clients and regulatory bodies. Collaborate with cross-functional teams (payer enrollment, provider data management, contracting). Required Qualifications Bachelor's degree or equivalent experience in healthcare administration, life sciences, or related field. 24 years of hands-on experience in healthcare provider credentialing (preferably BPO/KPO setup). Working knowledge of NCQA, URAC, and CMS credentialing standards. Familiarity with credentialing software tools (Cactus, Echo, CACTUS/Symplr, Medversant). Excellent attention to detail, time management, and organizational skills. Strong written and verbal communication skills for provider and client interactions. Proficiency in MS Excel, Outlook, and document management systems. Role & responsibilities

Continual development to be an expert with knowledge of respective clients Credentialing specialties. Exp:1-7Years Location: Bangalore @ Noida Shift : Night Required Candidate profile 1+ years experience in provider enrollment/credentialing / Voice Process. Skill Set: EFP, EDI, ERA preferred Immediate joiners preferred Call or Whatsapp 9989051577 Email: manijob7@gmail.com

We're Hiring: Business Development Executive, US Healthcare (Medical Billing & Credentialing) Location: Manekbaug, Ahmedabad 380015 (Relocating soon to Prahladnagar) Shift: US Shift (Night Shift) Work from Office Apply at: hr@collabglobus.com Company: Collab Softech Pvt Ltd. (www.collabsoftech.com.au) Experience Required: 13 Years At Collab Softech , we are expanding our presence in the US Healthcare outsourcing industry and are looking for a dynamic Business Development Executive to help us scale. If you have experience in Medical Billing, Credentialing, or RCM , and are driven by targets and client success, this opportunity is for you. Key Responsibilities: Identify and engage potential clients in the US healthcare sector (clinics, hospitals, billing companies, solo providers). Pitch a comprehensive suite of services, including Medical Billing, Provider and Facility Credentialing, as well as Revenue Cycle Management (RCM). Develop strategies for lead generation and outreach via email, LinkedIn, and other platforms. Maintain strong client relationships and act as a bridge between clients and delivery teams. Track and manage the sales pipeline using CRM tools; report progress and forecast to management. Research market trends, competition, and new business opportunities in the US healthcare space. Prepare business proposals, service decks, pricing models, and contracts. Must Have: Prior experience working with US-based clinics, medical billing firms, or provider credentialing services . Excellent communication & negotiation skills (US client handling experience preferred). Strong understanding of US healthcare processes and terminology (HIPAA, CMS, etc.). Willingness to work on the night shift (US time zone) . Were hiring! If you have the drive for business development and a background in US healthcare, this is your opportunity to shine.

Provider Credentialing (US healthcare medical billing) 1. Collect all the data and documents required for filing credentialing applications from the physicians 2. Store the documents centrally on our secure document management systems 3. Understand the top payers to which the practice sends claim and initiate contact with the payers 4. Apply the payer-specific formats after a due audit 5. Timely follow-up with the Payer to track application status 6. Obtain the enrolment number from the Payer and communicate the state of the application to the physician 7. Periodic updates of the document library for credentialing purposes. Required Candidate profile Desired Candidate Profile: 1. Should have worked as a Credentialing Analyst for at least 3-year medical billing service providers 2. Good Knowledge in Provider credentialing (Doctor side). 3. Good knowledge in clearing house setup - Electronic Data Interchange setup (EDI) - Electronic Remittance Advice Setup (ERA) - Establish Insurance Portals (EFT) 4. Experience in Insurance calling. 5. Good knowledge in filling insurance enrollment applications. 6. Good experience in CAQH, PECOS application. 7. Experience in Medicare, Medicaid, Commercial insurance enrollment. 8. Positive attitude to solve problems 9. Knowledge of generating aging report 10. Strong communication skills with a neutral accent Note: Minimum of 8 to 12 years of Provider Credentialing experience must. Location: Coimbatore (Onsite job) Preference will be given to candidates who can start immediately or with short notice. Candidates who are freshers or have experience in other domains are kindly requested not to apply for this position.

Summary Green Apples is looking for driven, dedicated and experienced Credentialing & Enrolment professionals, proficient in US healthcare, who are comfortable working in evening shift starting at 4pm IST. Noida based Company, currently working from home. Local candidates from Delhi-NCR only need to apply. Description Hiring multiple candidates with 1 year and more, hands-on working experience in Credentialling Candidates with minimum of 1 year experience in Credentialling & enrolment alone only need to apply. Should have knowledge base of end-to-end provider US healthcare credentialing. Should be able to work independently with minimum or no supervision. Should have experience in credentialing with Medicare, Medicaid, their HMOs and Commercial payers. Good experience n CAQH, PECOS application. Tracks expiration dates and maintains current state licenses, DEA certification, malpractice coverage and any other required documents for all providers. Malpractice coverage and any other required documents for all providers. Compiles information and sets up provider files Set up all ERA and EFT enrolments Completes initial provider credentialing applications, monitors applications and follows up as needed. Track all expired provider certification. Initiate re-credentialing application as requested by insurance companies. Collect all the data and documents required for filling credentialing application from the physicians/ clinics Store the documents centrally on our secure document management systems. Strong communication skills in English with a neutral accent. Detail-oriented with excellent follow-up abilities Proficiency in Microsoft office tools Ability to juggle multiple priorities successfully. Willingness to work in the evening shift Qualifications: Graduate/ Masters degree in the related field Capability to converse clearly and precisely with US clients and payers, credentialing department personnel, by phone and email Excellent computer skills Excellent command over English with excellent written and verbal communication skills Excellent management skills Excellent Analytical Skills. Perks and Benefits Perks and Benefits: As per industry standard

Hiring for Provider credentialing SPE / SME Loc: Pan India Shift : Us shift Work mode : Work from home Years of Exp: SPE : 1.5 yrs SME : 4 yrs Skill Excellent communication with experience in handling provider credentialing via Calls SPE - 1.5 yrs of min relevant exp , SME - 4 yrs of min relevant exp Notice : Immediate to max 30 days Location : PAN India - work from home For SME, people with QA experience and client facing experience will be an added advantage For SPE, any AR with excellent communication and willing to work on credentialing will also be considered Interested candidates contact HR Hema@9136535233/ hemavathi@careerguideline.com

Greetings from Intellisight India Pvt !!!!!!!!!!!!!!!!!!!! We have huge Job openings for Credentialing Specialists Responsibilities of a Credentialing Specialist Create and maintain licensing, credentials, and insurance records Conduct research on updated state and federal regulations and policies Release of information to requesting agencies and public inquiries when required by law Help develop internal provider credentialing processes Monitor license and credential expiration dates and advise staff members of required renewal by dates Ensure the facility and staff members are maintaining compliance with regulatory and accrediting institutions. Preferred Candidate Profile: 1 to 6 years of experience as a Credentialing Specialist in US healthcare. Strong understanding of healthcare concepts and denial management. Comfortable with fixed night shifts (6PM to 3AM) with transportation provided one way. Immediate joiners preferred. Perks and benefits : Best in Industry Monthly incentives Annual appraisals Saturday and Sunday are weekends off Quarterly Cash Rewards Company Description Intellisight India Pvt. Ltd. is a leading healthcare management company specializing in revenue cycle management solutions. Our primary goal is to optimize revenue and ensure compliance by leveraging high-end technology and personnel working together in an efficient and cost-effective manner. We have been providing exceptional services to a captive client in Cardiology, GI, and Surgical Center for the past 21 years, taking care of US medical billing and insurance-related activities. Intellisight is a one-stop solution center dedicated to allowing our clients to focus on providing healthcare while we handle their medical billing and related activities, resulting in reduced operating costs, increased revenues, and improved efficiency.

Continual development to be an expert with knowledge of respective clients Credentialing specialties. Exp:1-7Years Location: Bangalore @ Noida Shift : Night Required Candidate profile 1+ years experience in provider enrollment/credentialing / Voice Process. Skill Set: EFP, EDI, ERA preferred Immediate joiners preferred Call or Whatsapp 9989051577 Email: manijob7@gmail.com

Looking for minimum 1 year experince in Provider Credentialing or Provider Enrollment in Voice process Should be aware about CAQH / EFT / ERA or EDA Looking for immediate Joiners , virtual Interview available Contact 8977711182

Role: Credentialing Specialist You should have experience in provider enrollment/credentialing. Good understanding and working experience of the End-to-End Claim Resolution model. 2+ years experience in US Healthcare Revenue Cycle Management. Required Candidate profile Continual development to be an expert with knowledge of respective clients Credentialing specialties Attending meetings to enhance Credentialing knowledge Call /Whatsapp 9989051577 manijob7@gmail.com

Job Role: Credentialing Enrollment(Provider Side) Designation: Credentialing Specialist Qualification: Any UG & PG Degree/Diploma Exp:1-7Years Location: Bangalore @ Noida Shift : Night Required Candidate profile 1+ years experience in provider enrollment/credentialing / Voice Process. Skill Set: EFP, EDI, ERA preferred Immediate joiners preferred Call or Whatsapp 9989051577 Email: manijob7@gmail.com