CREDENTIALING EXECUTIVE

We are seeking a detail-oriented, organized, and motivated Credentialing Executive to join our team. The successful candidate will be responsible for managing the credentialing and enrollment processes for healthcare providers with various US insurance companies. This role requires ensuring accurate documentation, timely submission of applications, and strict compliance with payer requirements. The ideal candidate should have a solid understanding of US healthcare credentialing procedures and be capable of handling multiple tasks efficiently in a fast-paced environment.

Key Responsibilities:
- Manage the complete credentialing and provider enrollment process with US insurance companies from start to finish.
- Prepare, submit, and monitor credentialing and re-credentialing applications to ensure timely processing.
- Maintain and update provider profiles using CAQH and insurance payer portals.
- Verify essential provider credentials, including licenses, certifications, NPI details, malpractice insurance, and other required documentation.
- Follow up regularly with insurance companies regarding pending applications, approvals, and enrollment statuses.
- Ensure all provider documentation is accurate, complete, and consistently up to date.
- Maintain comprehensive credentialing records and track application deadlines and renewals to avoid lapses.
- Collaborate with internal teams to resolve any discrepancies or issues related to credentialing and enrollment.

Required Qualifications:
- Minimum of 6 months to 1 year of relevant experience in healthcare credentialing.
- Familiarity with CAQH, NPI, PECOS, and various insurance payer portals is preferred.
- Strong understanding of US healthcare credentialing and provider enrollment procedures.
- Excellent organizational skills with the ability to manage multiple priorities and meet deadlines.
- Effective communication and follow-up skills to coordinate with internal teams and external payers.
- High attention to detail to ensure accuracy in documentation and compliance.
- Proficiency in computer applications and documentation management systems.

Preferred Qualifications and Benefits:
- Experience working directly with US insurance companies and knowledge of their credentialing requirements is advantageous.
- Competitive salary range from Rs60,000 to Rs110,000 per month.
- This position requires in-person work, providing an opportunity to engage closely with the team and internal stakeholders.

This role offers a valuable opportunity for candidates looking to grow their career in healthcare credentialing within a dynamic and supportive environment. If you are motivated by accuracy, compliance, and efficient process management, this position could be an excellent fit.