Credentialing Specialist

Job Title : Credentialing Specialist Qualification : Any Graduates Relevant Experience : 2-6 Years Must Have Skills : 1. Provider enrollment and payer credentialing expertise 2. Strong knowledge of CAQH, Medicare, Medicaid, and commercial payer processes 3. Experience in contracting and re-credentialing workflows 4. Primary source verification and compliance management 5. Excellent communication and stakeholder management skills 6. Strong organizational and multitasking abilities Good Have Skills : 1. CPCS / CPMSM certification 2. Experience with U.S. healthcare systems and regulations Roles and Responsibilities : 1. Manage provider enrollment and payer credentialing processes for Medicare, Medicaid, and commercial payers 2. Maintain and update CAQH profiles, licenses, certifications, and insurance records 3. Conduct primary source verification and coordinate with providers/payers for approvals 4. Handle contracting, re-credentialing, renewals, and expirations 5. Ensure credentialing compliance with payer and regulatory standards 6. Track credentialing timelines and maintain accurate records in credentialing databases 7.Coordinate with internal teams and clients to resolve credentialing issues and delays 8. Deliver quality customer service throughout the credentialing lifecycle Location : Bengaluru CTC Range : 4 Lpa – 6.5 Lpa Notice Period : Immediate to 15 days Mode of Interview : Virtual Shift Timing : US Shift Mode of Work : Work from Office