Job Title: Credentialing Executive – Medical Billing Location: [Hyderabad] Job Type: [Full-time] Reports To: Manager Job Summary: The Credentialing Executive is responsible for overseeing and executing the provider credentialing and enrollment process with insurance payers to ensure that all healthcare professionals are properly credentialed and enrolled for reimbursement. This role is critical in preventing claim rejections, delays in payments, and maintaining overall billing compliance. Key Responsibilities: 1. Handle end-to-end provider credentialing and payer enrollment for new and existing healthcare providers. 2. Prepare and submit credentialing applications to government and commercial insurance payers, including Medicare, Medicaid, and private insurers. 3. Monitor and track the status of applications, follow up with payers, and ensure timely approvals. 4. Maintain accurate and up-to-date records of provider credentials, including licenses, board certifications, malpractice insurance, DEA registration, and other required documentation. 5. Update and manage provider profiles in credentialing databases and portals such as CAQH, PECOS, NPPES, and insurance payer websites. 6. Work closely with the medical billing team to ensure all credentialing information is correctly reflected in billing systems to prevent denials or payment issues. 7. Renew and re-credential providers as required by payers and regulatory agencies. 8. Identify and resolve credentialing-related issues and discrepancies that could affect billing and reimbursement. 9. Ensure compliance with all regulatory standards including NCQA, CMS, and payer-specific credentialing requirements. 10. Support audits by providing credentialing documentation and reports when requested. Required Qualifications: -High school diploma or equivalent; Associate’s or Bachelor’s degree in Healthcare Administration or related field preferred. -Minimum of 2–3 years of experience in provider credentialing and payer enrollment in a medical billing or RCM (Revenue Cycle Management) environment. -Strong knowledge of payer requirements and credentialing processes for Medicare, Medicaid, and commercial payers. -Proficiency with credentialing software and systems (e.g., CAQH, PECOS, NPPES, Availity). -Familiarity with billing systems and medical billing workflow (e.g., claim submissions, denials related to credentialing). -Strong attention to detail and organizational skills. -Excellent written and verbal communication skills. -Preferred Skills and Certifications: -Certified Provider Credentialing Specialist (CPCS) or Certified Medical Reimbursement Specialist (CMRS) – preferred but not required. -Experience with credentialing in a multi-provider or multi-specialty environment. -Ability to manage multiple priorities and meet deadlines in a fast-paced environment. Job Types: Full-time, Permanent Pay: ₹30,000.00 - ₹35,000.00 per month Benefits: Flexible schedule Health insurance Leave encashment Life insurance Paid sick time Paid time off Schedule: Evening shift Fixed shift Monday to Friday Night shift US shift Supplemental Pay: Overtime pay Performance bonus Work Location: In person

Job Summary: We are seeking a detail-oriented and proactive Authorization Specialist to join our medical billing team. This position is responsible for initiating and following up on prior authorizations for medical procedures, services, or medications by calling insurance companies and verifying patient coverage. The role plays a crucial part in ensuring timely approvals to support patient care and clean claims submission. Key Responsibilities: 1. Call insurance companies to initiate and obtain prior authorizations for medical procedures, diagnostic tests, surgeries, and other healthcare services. 2. Verify patient eligibility and benefits related to specific procedures or services. 3. Accurately document all calls, outcomes, and authorizations received in the billing or EMR system. 4. Follow up on pending authorizations to ensure timely approvals and minimize delays in patient care. 5. Work closely with providers, scheduling staff, and billing teams to coordinate patient services. 6. Identify and escalate issues with denials, coverage discrepancies, or authorization delays. 7. Stay up to date on payer-specific guidelines and policy changes. 8. Ensure compliance with HIPAA and patient confidentiality requirements. Qualifications: -High school diploma or equivalent; associate degree or certification in medical billing/coding is a plus. -Minimum 1–2 years of experience in medical billing, insurance verification, or prior authorization. -Strong understanding of medical terminology, CPT/ICD codes, and insurance guidelines. -Excellent verbal communication skills—must be comfortable speaking with insurance reps over the phone. -Ability to work in a fast-paced, deadline-driven environment. -Experience with EMR systems and billing software preferred. -Strong attention to detail and organizational skills. Preferred Skills: -Experience with payers like Medicare, Medicaid, Blue Cross, Aetna, Cigna, etc. -Familiarity with outpatient, inpatient, or specialty-specific authorization workflows. -Bilingual skills are a plus (especially Spanish, depending on the patient population). Job Types: Full-time, Permanent Pay: ₹32,000.00 - ₹35,000.00 per month Benefits: Flexible schedule Health insurance Leave encashment Life insurance Paid sick time Paid time off Schedule: Evening shift Monday to Friday Night shift Supplemental Pay: Overtime pay Work Location: In person

Responsibilities Develop and implement recruitment strategies to attract and retain top talent. Collaborate with hiring managers to identify job requirements and create job descriptions. Manage full cycle recruiting process including sourcing, screening, interviewing, and onboarding candidates. Mentor and train junior recruiters to enhance their recruiting skills. Utilize various sourcing methods including job boards, social media, and professional networks. Maintain accurate records of recruitment activities and provide regular reports to HR leadership. Stay current on industry trends and best practices in talent acquisition. Ensure a positive candidate’s experience throughout the recruitment process. Qualifications Bachelor’s degree in human resources, Business Administration, or a related field. 5+ years of experience in recruitment, with at least 2 years in a senior or lead role. Proven track record of successful hiring across various job levels and functions. Strong understanding of recruitment practices, talent market trends, and employment law. Excellent communication and interpersonal skills. Ability to handle multiple priorities and work in a fast-paced environment. Proficiency in using applicant tracking systems (ATS) and recruiting software. Skills Sourcing Interviewing Onboarding Applicant Tracking Systems (ATS) Social Media Recruiting Job Boards Talent Acquisition Communication Employee Relations Strategic Planning Job Types: Full-time, Permanent Pay: ₹13,852.47 - ₹43,123.38 per month Benefits: Cell phone reimbursement Health insurance Life insurance Schedule: Evening shift Fixed shift Monday to Friday US shift Work Location: In person Application Deadline: 29/06/2025