Job Summary

We are seeking a detail-oriented and organized Credentialing Executive to manage provider credentialing, enrollment, and contracting with commercial insurance companies, Medicare, Medicaid, and other healthcare payers. The ideal candidate should have experience with provider enrollment processes, payer portals, and healthcare credentialing requirements while ensuring timely completion of applications and maintaining compliance.

Key Responsibilities
- Complete provider enrollment and credentialing applications with commercial insurance companies, Medicare, Medicaid, and other government payers.
- Manage recent provider enrollments, recredentialing, and provider demographic updates.
- Submit and track applications through payer portals such as CAQH, PECOS, Availity, Optum, and other payer websites.
- Maintain and update provider information in CAQH ProView, NPPES, and PECOS.
- Follow up with insurance companies regarding credentialing status and resolve enrollment issues.
- Coordinate with providers to obtain required documentation, including licenses, malpractice insurance,



W-9s, DEA certificates, board certifications, and other credentialing documents.
- Maintain credentialing trackers and provide regular status updates to management and clients.
- Assist with EDI, ERA, EFT, and payer portal enrollments when required.
- Maintain accurate records of provider credentials and monitor expiration dates for licenses, certifications, and malpractice insurance.
- Communicate professionally with insurance representatives, providers, and internal teams.
- Ensure compliance with payer guidelines and regulatory requirements.
- Perform other credentialing-related duties as assigned.

Required Qualifications
- Bachelor's degree preferred.
- 13 years of experience in healthcare credentialing or provider enrollment.
- Experience working with commercial insurance companies, Medicare, and Medicaid.
- Knowledge of CAQH, PECOS, NPPES, Availity, and provider enrollment proces

📌 Walk-in || Credentialing Specialist | Healthcare BPO | US Medical Billing (Chennai)
🏢 Anicut Healthcare Solutions
📍 Chennai