Job DescriptionCompany: Credifide Location: Mohali Shift: US Timings Working Days: Monday to Friday (On-site) Job Type: Full time Role Summary The Credentialing Specialist is responsible for managing the end-to-end provider enrollment and primary source verification process for an assigned caseload of providers. This role ensures insurance panel applications, re-credentialing, and hospital privileging are completed accurately and on schedule, working closely with the Credentialing Team Lead on complex or escalated files. Key Responsibilities Application Management: Prepare, submit, and follow up on initial credentialing and re-credentialing applications for various specialties (Medicare, Medicaid, and Commercial payers). Primary Source Verification: Conduct primary source verification of provider education, licensure, certifications, and work history in line with NCQA and payer standards. Data Management: Maintain accurate, up-to-date provider profiles in CAQH, NPPES, and PECOS. Quality Control:



Review own applications for accuracy and completeness before submission to minimize delays or denials. Payer Follow-up: Track submitted applications and follow up with payers to resolve pended applications, enrollment discrepancies, or missing information. Compliance Monitoring: Monitor expiration dates for provider licenses, DEAs, and board certifications, and initiate timely renewals. Reporting: Keep the centralized tracking database/spreadsheet updated with the current status of assigned provider files. Collaboration: Escalate complex credentialing roadblocks or multi-state enrollment issues to the Team Lead/Manager as needed. Required Skills & Experience Experience : 3-4 years of experience in medical credentialing and provider enrollment. Knowledge: Working knowledge of NCQA standards, CMS guidelines, and state-specific payer requirements. Technical Proficiency: Hands-on experience with CAQH ProView, PECOS, and NPPES (NPI) portals. Proficient in Excel for data tracking.

📌 Credentialing Specialist (Sahibzada Ajit Singh Nagar)
🏢 Credifide
📍 Sahibzada Ajit Singh Nagar