Team Lead - Credentialing | Noida

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Job Summary:

Team Leader – Credentialing

Responsibilities:

• Lead and supervise daily operations of the credentialing team, ensuring adherence to client, payer, and regulatory guidelines.
• Manage end-to-end provider enrollment and re-credentialing processes with insurance networks, hospitals, and healthcare facilities.
• Review provider documentation for accuracy, completeness, and compliance prior to submission.
• Monitor turnaround times and ensure timely completion of credentialing tasks.
• Serve as the primary escalation point for complex credentialing issues, collaborating with payers and providers for resolution.
• Train, mentor, and evaluate team members to uphold quality standards and meet productivity goals.
• Generate and analyze reports on credentialing status, performance metrics, and compliance indicators.
• Coordinate with internal departments, clients, and third-party entities to streamline credentialing workflows.
• Stay updated on payer policies, NCQA standards, and healthcare compliance regulations.
• Identify and implement process improvements to enhance operational efficiency and client satisfaction.

Mandatory Skills:

• Strong expertise in

  Credentialing

  ,

  Provider Enrollment

  , and

  US Healthcare Regulations

• Proven leadership and team management capabilities
• Excellent communication and problem-solving skills
• Proficiency in credentialing software and reporting tools