Licensing and Payor Enrollment Specialist

Location: Pune, Maharashtra

Work Mode: Work from Office

Experience: 1–3 Years

Employment Type: Full-time

Job Summary

We are looking for a detail-oriented and proactive Licensing and Payor Enrollment Specialist to manage the end-to-end provider enrollment process with commercial insurance payors, Medicare, Medicaid, and other government health plans.

The ideal candidate will be responsible for accurate and timely submission of enrollment applications, maintaining provider records, coordinating with internal teams, and ensuring successful provider onboarding and uninterrupted reimbursement.

Key Responsibilities

- Complete and submit provider enrollment, revalidation, and re-enrollment applications with commercial and government payors.
- Manage provider enrollment through various payer portals and applications.
- Maintain and update provider information in CAQH and other enrollment databases.
- Track enrollment applications and follow up with insurance companies to ensure timely processing.
- Coordinate with credentialing, licensing, and operations teams to obtain required documentation.
- Resolve enrollment-related issues by communicating with payors and internal stakeholders.
- Maintain accurate records of application status, approvals, expirations, and renewals.
- Ensure compliance with payer guidelines, regulatory requirements, and organizational policies.




- Prepare enrollment status reports and maintain proper documentation.
- Assist with provider onboarding and offboarding activities related to payor enrollment.

Required Qualifications

- Bachelor's degree in any discipline.
- 1–3 years of experience in US Healthcare Payor Enrollment, Provider Enrollment, Credentialing, or related healthcare operations.
- Strong understanding of Medicare, Medicaid, and commercial payor enrollment processes.
- Experience with CAQH, NPPES, PECOS, and insurance payer portals is preferred.
- Excellent written and verbal communication skills.
- Strong attention to detail and organizational skills.
- Ability to manage multiple tasks and meet deadlines in a rapid-paced environment.
- Proficiency in Microsoft Excel, Word, and Outlook.

Preferred Skills

- Knowledge of provider credentialing and licensing processes.
- Experience with healthcare practice management or credentialing software.
- Strong analytical and problem-solving abilities.
- Ability to work independently while collaborating effectively with cross-functional teams.
- Familiarity with HIPAA compliance and healthcare regulations.

What We Offer

- Professional growth and learning opportunities.
- Collaborative and supportive work environment.
- Competitive compensation and performance-based growth.

Pay: ₹25,000.00 - ₹30,000.00 per month

Work Location: In person

📌 Licensing and Payor Enrollment Specialist (Pune)
🏢 TGS The Global Skills
📍 Pune