Credentialing Specialist (India)

Credentialing Specialist (India)

13 Sep
|
Pinnacle medical billing and coding solutions
|
India

13 Sep

Pinnacle medical billing and coding solutions

India

Pinnacle Medical Billing & Coding Solutions

Position: Credentialing Expert

Employment Type: Part-Time

Location: Remote (Work From Home)

Company: Pinnacle Medical Billing & Coding Solutions

About Pinnacle Medical Billing

Pinnacle Medical Billing & Coding Solutions is a fast-growing U.S. Revenue Cycle Management (RCM) company providing end-to-end medical billing, coding, credentialing, AR follow-up, payment posting, and eligibility verification services to healthcare providers across the United States.

We are seeking a detail-oriented Credentialing Expert with hands-on experience in Washington State provider credentialing to join our growing RCM team.

Job Overview The Credentialing Expert will manage the complete provider credentialing and enrollment process for healthcare providers practicing in Washington State. This role requires experience working with Washington Medicaid (Apple Health), commercial insurance payers, CAQH, PECOS, and payer enrollment portals.

Key Responsibilities

- Manage end-to-end provider credentialing, recredentialing, and enrollment with insurance payers.
- Complete credentialing for physicians, behavioral health providers, massage therapists, counselors, physical therapists, and other healthcare professionals.
- Maintain and update CAQH profiles, NPI records, licenses, malpractice insurance, and provider documentation.
- Submit credentialing and contracting applications to commercial and government payers.
- Follow up with insurance companies until credentialing and enrollment are approved.
- Process provider demographic updates, revalidations, and payer maintenance requests.
- Track credentialing status, expiration dates, renewals, and provider participation.
- Coordinate with providers to collect required documentation and signatures.




- Maintain accurate credentialing logs and ensure timely completion of all applications.
- Ensure compliance with HIPAA, payer guidelines, and Washington State credentialing requirements.

Required Experience
- Minimum 2 years of U.S. healthcare credentialing experience.
- Mandatory experience credentialing providers in Washington State.
- Experience with Washington Apple Health (HCA/Medicaid) provider enrollment.
- Experience working with commercial insurance payers, including Premera Blue Cross, Regence BlueShield, Molina Healthcare, Coordinated Care, CHPW, Aetna, Cigna, UnitedHealthcare, and other major payers.
- Strong knowledge of CAQH, PECOS, NPI, and provider enrollment portals.

Qualifications
- Excellent communication and follow-up skills.
- Strong attention to detail and documentation management.
- Ability to manage multiple credentialing applications simultaneously.
- Proficiency in Microsoft Excel, Outlook, and credentialing portals.
- Ability to work independently and meet deadlines.

Preferred Skills
- Experience in Behavioral Health, Physical Therapy, Massage Therapy, or Primary Care credentialing.
- Knowledge of payer contracting and provider enrollment processes.
- Familiarity with U.S. Revenue Cycle Management workflows.

What We Offer
- Flexible Part time Remote opportunity.
- Competitive compensation based on experience.
- Opportunity to work with a growing U.S. medical billing company.
- Professional, supportive, and collaborative work environment.
- Career growth opportunities within Pinnacle Medical Billing & Coding Solutions.

How to Apply

Email your updated CV to:

[email protected]

Subject: Application – Credentialing Expert (Washington State)

Pay: ₹10,000.00 - ₹20,000.00 per month

Benefits

- Flexible schedule
- Work from home

Work Location: Remote

📌 Credentialing Specialist (India)
🏢 Pinnacle medical billing and coding solutions
📍 India

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