Job Description

Dear Candidate,

n

About Company

n

Edvak is a US-based SaaS company transforming the healthcare sector with our cutting-edge 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.

n

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.

n

Website: www.edvak.com

n

Address:

n

IndiQube Pearl, Beside Rolling Hills and Ramky Towers, Mindspace Rd, P Janardhan Reddy Nagar, Gachibowli, Telangana 500032

n

Position: Provider Credentialing Associate

n

Experience: 3–5 Years preferred

n

Domain: US Healthcare / Provider Credentialing

n

Responsibility: Independent end-to-end management of assigned client accounts

n

We are looking for an experienced Provider Credentialing Associate who can independently manage the complete credentialing and payer enrollment activities for an assigned healthcare client.

n

Key Responsibilities

n

n
- Independently manage provider credentialing and enrollment for assigned clients.
n
- Complete initial credentialing, recredentialing, and payer enrollment with Medicare, Medicaid, and commercial insurance plans.
n
- Maintain and update CAQH profiles and attestations.
n
- Handle PECOS, NPPES, state Medicaid portals, Availity, payer portals, and other enrollment systems.
n
- Submit and follow up on group and individual provider enrollments.
n
- Manage NPI–TIN affiliations, practice/location additions, demographic changes, EFT and ERA enrollments.
n
- Track applications from submission through approval and maintain accurate credentialing trackers.
n
- Follow up directly with payers regarding pending, returned,



or rejected applications.
n
- Verify effective dates and participation/network status before communicating completion.
n
- Maintain provider documents such as licenses, DEA, malpractice insurance, W-9, board certifications, and other required credentials.
n
- Monitor expiration dates and proactively initiate renewals/recredentialing.
n
- Coordinate directly with providers/practice administrators to obtain missing documentation.
n
- Communicate credentialing status, pending items, risks, and expected timelines clearly to the client.
n
- Coordinate with the billing team to ensure claims are submitted only according to the provider's payer enrollment/effective-date status.
n
- Troubleshoot enrollment-related claim issues such as provider not enrolled, NPI/TIN mismatch, invalid Medicaid provider ID, and provider not affiliated with the group.
n
- Maintain confidentiality and follow HIPAA requirements.
n

n

Required Skills

n

n
- 3–5 years of hands-on US healthcare provider credentialing/enrollment experience.
n
- Strong experience with Medicare, Medicaid, and commercial payer enrollment.
n
- Working knowledge of CAQH, PECOS, NPPES, Availity and payer portals.
n
- Understanding of Type 1/Type 2 NPI, TIN, PTAN, taxonomy, group affiliations, ERA and EFT enrollment.
n
- Strong payer follow-up and documentation skills.
n
- Excellent written and verbal communication.
n
- Ability to independently own a client account, prioritize pending items, and provide regular status updates with minimal supervision.
n

n

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 (Hyderabad)
🏢 Edvak EHR
📍 Hyderabad