Credential Specialist-State of Nevada

3 hours ago

New Delhi Delhi India, Delhi Macro Outsourcing Full time

Company Description

Macro Outsourcing is a Business Process Outsourcing company that provides transcription, billing, and document management services to medical clinics and physicians in the United States. Our mission is to enhance the efficiency and manageability of back-office operations like medical transcription and billing, maintaining high quality and security standards as required by the healthcare sector and HIPAA regulations. Our team includes finance, technical, medical, and legal professionals with significant industry expertise. Macro focuses on customer satisfaction, excellence in service, and innovation to add value to our users.

Role Description (Credentialing Specialist – State of Nevada)

Position: Full-time

Location: Delhi

Overview:

The Credentialing Specialist will manage credentialing, recredentialing, provider enrollment, and privileging workflows for healthcare providers associated with Nevada-based health systems. The role requires strong documentation accuracy, regulatory understanding, and effective communication with providers, payers, and internal departments.

Responsibilities:

  • Process and maintain initial credentialing and recredentialing files in compliance with Nevada state regulations, NCQA, CMS, and organizational policies.
  • Verify provider qualifications including licensure (NV Board of Medical Examiners/Nursing Board), education, training, board certifications, work history, and malpractice coverage.
  • Prepare and submit applications to commercial insurance plans, Medicare, Medicaid (Nevada Medicaid/Nevada Check Up), and other payers.
  • Track expiring documents and ensure timely updates for licenses, DEA registrations, malpractice insurance, and other required credentials.
  • Maintain accurate, confidential provider records within credentialing software systems.
  • Communicate with providers, practice managers, payers, and internal departments to resolve credentialing issues or requests for information.
  • Support the privileging process for Nevada-based hospitals and facilities, ensuring required documentation is complete and compliant.
  • Assist with internal and external audits and quality reviews.
  • Keep current with Nevada-specific regulatory changes affecting credentialing and provider enrollment.

Qualifications

Required:

  • High school diploma or equivalent (Associate’s or Bachelor’s preferred).
  • Experience in credentialing or provider enrollment, preferably in Nevada.
  • Strong knowledge of CMS, NCQA, Medicare/Medicaid, and commercial payer requirements.
  • Experience with credentialing platforms such as CAQH, ProviderSource, Echo, etc.
  • Excellent attention to detail and strong organizational abilities.
  • Effective verbal and written communication skills.
  • Ability to manage multiple provider files and meet strict deadlines.

Preferred:

  • CPCS (Certified Provider Credentialing Specialist) or CPMSM certification.
  • Experience with Nevada Medicaid systems, Nevada Board portals, and major Nevada health networks.
  • Familiarity with hospital privileging requirements and medical staff bylaws.


  • Medical Credentialing Specialist

    5 days ago

    Delhi, Delhi, India Naukri Healthcare Jobs Full time ₹ 8,00,000 - ₹ 12,00,000 per year

    We are looking for a highly skilled and experienced Medical Credentialing Specialist to join our team at beBeeMedicals. The ideal candidate will have 2-5 years of experience in medical credentialing, with a strong background in the field.Roles and ResponsibilityManage and process medical credentials for healthcare providers.Ensure compliance with regulatory...

  • Healthcare Specialist

    2 weeks ago

    Delhi, Delhi, India 85dc15cc-2714-46ec-bf98-9cc73d04fcf6 Full time ₹ 5,00,000 - ₹ 15,00,000 per year

    Role DescriptionThis is an on-site contract role for a Healthcare Specialist located in Delhi. The Healthcare Specialist will be responsible for providing quality medical care, assisting with emergency medical services (EMS), and delivering healthcare training to patients and staff. The role involves effective communication with team members and patients to...

  • Principal Manager, State Expansion

    2 weeks ago

    Delhi, Delhi, India Evidence Action Full time US$ 80,000 - US$ 1,20,000 per year

    This position is with EAII Advisors, Evidence Action's technical partner in India.About EAII EAII Advisors, Evidence Action's technical partner in India, supports state governments in delivering evidence-based public health programs, including safe drinking water initiatives and school and Anganwadi-based National Deworming Day and iron and folic acid...

  • Enrollments Specialist

    3 days ago

    Delhi, Delhi, India Osmind Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    About UsOsmind is a technology, services, and data company focused exclusively on psychiatry. Mental health disorders are one of the leading causes of death worldwide and are tied to shortening lifespans. Yet, we have cause for hope: there have been developments in new psychiatric medications since the first FDA approval in 1954, such as new treatments like...

  • Business Development Specialist

    1 week ago

    Delhi, Delhi, India Member of Parliament Full time ₹ 2,00,000 - ₹ 6,00,000 per year

    Company DescriptionWe suggest you enter details here.Role DescriptionThis is a full-time on-site role for a Business Development Specialist located in Delhi, India. The Business Development Specialist will be responsible for generating leads, conducting market research, analyzing data, providing customer service, and improving communication strategies. Other...

  • Cyber Threat Researcher

    4 hours ago

    New Delhi, Delhi, India, Delhi 3Columns Full time

    3Columns is a specialist cybersecurity firm that delivers a wide range of services, including security assurance, security governance, professional services, and managed services. Solutions include managed security services, offensive security services, cybersecurity consulting, and professional services to help customers deploy all the necessary controls....

  • Medical Biller

    3 days ago

    Delhi, Delhi, India Neolytix Full time ₹ 2,00,000 - ₹ 6,00,000 per year

    Neolytix is a multi-line Management Service Organization (MSO) providing support to the smaller healthcare providers and practices so they can remain competitive in our Healthcare system. Together with Practice Tech Solutions (digital division), we provide end-to-end nonclinical services to healthcare providers.Medical Billing Specialist is responsible for...

  • Marketing Automation Specialist

    5 days ago

    Delhi, Delhi, India Unloq Full time ₹ 70,00,000 - ₹ 1,45,00,000 per year

    Unloq is part of Linklogis Group, an award-winning leader in supply chain finance. With deep expertise in serving major buyers in North America, Europe and Asia, Unloq makes trade financing simple across global corridors. We've built unique knowledge and expertise that allows us to move faster, improve processes, and deliver smarter financial solutions. Our...

  • Talent Acquisition Executive

    5 days ago

    Delhi, Delhi, India Orion Group Of Hotels Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Company DescriptionOrion Hotels is a leading premium hotel chain dedicated to providing exceptional hospitality services both in India and internationally. With 12 strategically located hotels under its banner, the brand ensures easy access to major attractions and public transportation. Guests can enjoy state-of-the-art facilities, including high-speed...

  • Freelance Healthcare Recruiter

    3 days ago

    Delhi, Delhi, India Fortune Careers Limited Full time ₹ 12,00,000 - ₹ 36,00,000 per year

    Freelance Sr Healthcare Recruiter - US Staffing (Remote - Anywhere in India)Attractive commission structure per W2 placementWork from anywhereA strong US healthcare recruitment experience is requiredNeed to have your own network or job sites to find US healthcare professionals Your own laptop and VOIP to call candidates in the United StatesWe are seeking an...