Key Responsibilities

- Perform end-to-end provider credentialing and re-credentialing activities.
- Prepare, review, and submit credentialing applications to commercial, Medicare, and Medicaid payers.
- Verify provider qualifications including licenses, certifications, education, training, work history, and malpractice history.
- Maintain accurate and up-to-date provider credentialing files and databases.
- Track credentialing status, expirations, and renewals to ensure timely re-credentialing.
- Follow up with payers, providers, and internal teams to resolve delays or discrepancies.
- Ensure compliance with NCQA, CMS, state regulations, and payer-specific requirements.
- Conduct regular audits of credentialing files to ensure accuracy and completeness.
- Prepare and share credentialing status reports with management or clients.
- Support provider enrollment, terminations, and demographic updates as required.

Required Qualifications
- 23 years of experience in healthcare credentialing or provider enrollment.
- Strong knowledge of credentialing processes, payer requirements, and compliance standards.




- Familiarity with Medicare, Medicaid, and commercial payer portals.
- Experience with credentialing software and provider databases.
- Excellent organizational and documentation skills.
- Solid written and verbal communication skills.
- Ability to manage multiple providers and deadlines effectively.
- High attention to detail and accuracy.

Preferred Skills
- Knowledge of NCQA and CMS guidelines.
- Experience handling audits and re-credentialing cycles.
- Proficiency in Microsoft Office (Excel, Word).
- Ability to work independently and collaboratively in a team environment.
- Problem-solving mindset with proactive follow-up skills.

Key Competencies
- Compliance & Quality Focus
- Time Management
- Provider & Payer Coordination
- Analytical & Documentation Skills
- Client Communication.

Thank you! Rakesh HR [email protected]

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Note: Looking for Immediate Joiners

📌 Walk-in || Credentialing Specialist (Coimbatore)
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📍 Coimbatore