Job Summary

We are looking for a detail-oriented Credentialing Executive to manage healthcare provider credentialing, enrollment, and verification activities. The candidate will be responsible for ensuring providers are properly enrolled and credentialed with insurance companies, government payers, and healthcare networks while maintaining accurate documentation and compliance.

Key Responsibilities

- Manage end-to-end provider credentialing and re-credentialing processes.
- Prepare, verify, and submit provider credentialing applications to insurance companies and healthcare payers.
- Maintain and update provider information in CAQH and other payer portals.
- Verify provider licenses, certifications, NPI, DEA, malpractice insurance, and other required credentials.
- Follow up with insurance companies and payers regarding enrollment and credentialing status.
- Track application submissions, pending requirements, approvals, and expirations.
- Maintain accurate credentialing records and documentation.
- Identify missing or expired documents and coordinate with providers to obtain updates.
- Handle payer enrollment, provider additions, terminations, and demographic changes.
- Ensure credentialing activities are completed within defined timelines and follow client requirements.
- Communicate with US healthcare clients, providers, and insurance representatives through email and other communication channels.




- Prepare regular status reports and maintain credentialing trackers.
- Follow HIPAA and client-specific data privacy and security requirements.

Required Skills

- Knowledge of US Healthcare RCM and Provider Credentialing.
- Working knowledge of CAQH, NPI, PECOS, Medicare/Medicaid, and commercial payers.
- Good understanding of provider enrollment and re-credentialing processes.
- Excellent attention to detail and documentation skills.
- Valuable written and verbal English communication.
- Good follow-up and coordination skills.
- Ability to work with multiple providers and payer requirements simultaneously.
- Basic knowledge of MS Excel and other documentation tools.

Preferred Qualifications

- Any graduate degree.
- Prior experience in US Healthcare RCM / Medical Billing / Provider Credentialing / Payer Enrollment will be preferred.
- Experience working with US healthcare clients is an added advantage.

Key Performance Indicators

- Timely completion of credentialing and enrollment applications.
- Accuracy of provider information and documentation.
- Effective follow-up on pending applications.
- Reduction of credentialing-related delays and denials.
- Proper maintenance of credentialing records and trackers.

Pay: ₹35,000.00 - ₹55,000.00 per month

Benefits:

- Commuter assistance
- Health insurance
- Leave encashment
- Paid time off
- Provident Fund

Work Location: In person

📌 RCM - Credentialing (Kochi)
🏢 Sara infotech
📍 Kochi