Walk-in Credentialing Analyst

Candidates must be based out of Chennai and should be comfortable to attend face to face interview only should apply.

NO VIRTUAL INTERVIEWS!!

Job Summary:
The Credentialing Specialist is responsible for verifying the credentials of healthcare providers, maintaining up-to-date records, and ensuring compliance with state, federal, and payer regulations. The role involves managing provider enrollment, re-credentialing, and communication with insurance payers and providers.

Key Responsibilities:

• Collect, verify, and maintain provider credentials including licenses, certifications, education, and work history.
• Prepare and submit enrollment and re-enrollment applications to payers (Medicare, Medicaid, commercial insurers) for both group and providers.
• Monitor expirable such as licenses, insurance, and board certifications to ensure timely renewals.
• Update provider data in credentialing databases and CAQH profiles.
• Coordinate with providers and internal teams to resolve application discrepancies or delays.
• Maintain confidentiality and compliance with NCQA, CMS, and HIPAA standards.
• Assist in audits and provide accurate credentialing documentation as needed.

Qualifications:

• Associate or bachelors degree preferred.
• Minimum 3+ years of experience in medical credentialing or provider enrollment.
• Knowledge of payer portals, CAQH, and credentialing software (e.g., Echo, Modio, OneApp).
• Strong attention to detail and organizational skills.
• Excellent communication and follow-up skills.