Credentialing And Provider Enrollment Specialist

Summary

Join our team as a Credentialing & Provider Enrollment Specialist! This role involves managing provider credentialing, enrollment processes, and regulatory compliance to ensure timely onboarding and reimbursement. You will work with healthcare providers, payers, and internal teams to minimize claim denials and maintain network participation. We seek a detail-oriented and organized professional with 1-5 years of experience in healthcare credentialing and proficiency in CAQH, PECOS, and other credentialing platforms. The position offers remote work in Gurugram, India, and the opportunity to collaborate with key stakeholders in Revenue Cycle Management (RCM). This role is part of a dynamic team focused on compliance and efficiency in healthcare operations.

Requirements

• 1-5 years of experience in healthcare credentialing
• Proficiency in CAQH, PECOS, and other credentialing platforms

Responsibilities

• Manage provider credentialing
• Manage enrollment processes
• Ensure regulatory compliance to ensure timely onboarding and reimbursement
• Work closely with healthcare providers, payers, and internal teams to minimize credentialing-related claim denials and maintain network participation

Preferred Qualifications

• Strong understanding of Medicare, Medicaid, and commercial payer compliance
• Detail-oriented and organized

Benefits

• Be part of a dynamic team ensuring compliance and efficiency in healthcare operations
• Work remotely
• Company values accuracy, compliance, and operational excellence
• Opportunity to collaborate with key stakeholders in Revenue Cycle Management (RCM)