02 Sep
|
Edvak EHR
|
Mumbai
Dear Candidate,
About Company
Edvak is a US-based SaaS company transforming the healthcare sector with our creative AI solutions. We are dedicated to excellence, creativity, and innovation, delivering exceptional services to our clients. Our operations in India are based in the vibrant city of Hyderabad.As we continue to expand, we are looking for a dynamic Content Strategist/Marketer to lead our content marketing efforts and drive Edvak's success in a competitive market.
Website: www.edvak.com
Address:IndiQube Pearl, Beside Rolling Hills and Ramky Towers, Mindspace Rd, P Janardhan Reddy Nagar, Gachibowli, Telangana 500032
Position:
Provider Credentialing AssociateExperience:
3–5 Years preferredDomain:
US Healthcare / Provider CredentialingResponsibility:
Independent end-to-end management of assigned client accountsWe are looking for an experienced
Provider Credentialing Associate
who can independently manage the complete credentialing and payer enrollment activities for an assigned healthcare client.
Key ResponsibilitiesIndependently manage provider credentialing and enrollment for assigned clients.Complete
initial credentialing, recredentialing, and payer enrollment
with Medicare, Medicaid, and commercial insurance plans.Maintain and update
CAQH
profiles and attestations.Handle
PECOS, NPPES, state Medicaid portals, Availity, payer portals , and other enrollment systems.Submit and follow up on
group and individual provider enrollments .Manage
NPI–TIN affiliations, practice/location additions, demographic changes, EFT and ERA enrollments .Track applications from submission through approval and maintain accurate credentialing trackers.Follow up directly with payers regarding pending, returned,
or rejected applications.Verify
effective dates and participation/network status
before communicating completion.Maintain provider documents such as licenses, DEA, malpractice insurance, W-9, board certifications, and other required credentials.Monitor expiration dates and proactively initiate renewals/recredentialing.Coordinate directly with providers/practice administrators to obtain missing documentation.Communicate credentialing status, pending items, risks, and expected timelines clearly to the client.Coordinate with the billing team to ensure claims are submitted only according to the provider's payer enrollment/effective-date status.Troubleshoot enrollment-related claim issues such as
provider not enrolled, NPI/TIN mismatch, invalid Medicaid provider ID, and provider not affiliated with the group .Maintain confidentiality and follow HIPAA requirements.
Required Skills3–5 years of hands-on
US healthcare provider credentialing/enrollment
experience.Strong experience with
Medicare, Medicaid, and commercial payer enrollment .Working knowledge of
CAQH, PECOS, NPPES, Availity and payer portals .Understanding of
Type 1/Type 2 NPI, TIN, PTAN, taxonomy, group affiliations, ERA and EFT enrollment .Strong payer follow-up and documentation skills.Excellent written and verbal communication.Ability to
independently own a client account , prioritize pending items, and provide regular status updates with minimal supervision.
Preferred Candidate:
Someone who can take complete ownership of a client from
provider onboarding → credentialing/enrollment → payer follow-up → approval/effective-date verification → handoff to billing , while serving as the primary credentialing point of contact for the client.
📌 Provider Credentialing Associate – Client Account Management (Mumbai)
🏢 Edvak EHR
📍 Mumbai