– Credentialing Executive

Job Title: Credentialing Executive / Credentialing Specialist

Industry: Healthcare RCM / Medical Billing BPO

Location: Coimbatore

Experience: 1–5 Years

Employment Type: Full-Time

Shift: US Shift / Night Shift

Candidate Type: Experienced Candidates Only

Package: Based on Experience

Job Summary

We are looking for an experienced Credentialing Executive / Credentialing Specialist to handle end-to-end provider credentialing and enrollment activities for the US healthcare process.

The candidate will be responsible for collecting, verifying, maintaining, and submitting healthcare provider information and credentialing documents to insurance companies, government payers, and other healthcare organizations.

Key Responsibilities

- Handle end-to-end US Healthcare Provider Credentialing and Re-Credentialing.
- Collect and verify provider documents including medical licenses, DEA certificates, NPI, board certifications, malpractice insurance, CAQH, education, training, and work history.
- Maintain and update provider information in CAQH and payer portals.
- Prepare and submit provider enrollment and credentialing applications.
- Follow up with insurance payers regarding application status, pending documents, and approvals.
- Perform primary source verification (PSV) as required.
- Track credentialing applications and maintain accurate status reports.
- Monitor license, certification, and credential expiration dates and initiate timely renewals.
- Identify discrepancies in provider information and coordinate for corrections.
- Maintain accurate credentialing records and documentation.
- Ensure all activities meet defined TAT, productivity, and quality standards.
- Prepare regular MIS and process reports.




- Coordinate with internal teams, healthcare providers, and US insurance payers.

Required Skills
- Hands-on experience in US Healthcare Credentialing / Provider Enrollment.
- Valuable understanding of US Healthcare RCM processes.
- Knowledge of CAQH, NPI, DEA, Medicare, Medicaid, and commercial payers.
- Experience working with payer portals and credentialing applications.
- Good knowledge of MS Excel and documentation management.
- Strong attention to detail and accuracy.
- Good communication and follow-up skills.
- Ability to manage multiple credentialing cases simultaneously.
- Ability to meet process TAT and quality requirements.

Preferred Experience Candidates with experience in the following areas will be preferred:
- US Healthcare Credentialing
- Provider Enrollment
- Provider Credentialing
- CAQH Management
- Payer Enrollment
- Provider Data Management
- US Medical Billing / RCM
- Healthcare BPO Operations

Educational Qualification

Any Graduate / Postgraduate

Healthcare Management or a related qualification will be an added advantage.

Candidate Profile

- Experienced candidates only.
- Prior experience in US Healthcare Credentialing / Provider Enrollment is preferred.
- Should have strong knowledge of US healthcare payer processes.
- Should be detail-oriented and organized.
- Should have excellent follow-up and coordination skills.
- Should be comfortable working in US/night shifts.

Compensation Package: Based on relevant experience, skills, and current industry standards.

Location: Coimbatore

Shift: US Shift / Night Shift

Experience: Experienced Candidates Only

Industry: Healthcare RCM / BPO

Pay: ₹35,000.00 - ₹60,000.00 per month

Benefits

- Paid sick time
- Provident Fund

Work Location: In person

📌 Credentialing Specialist (Coimbatore)
🏢 Ranjitha tex
📍 Coimbatore