Credentialing SME

4 weeks ago

New Delhi, India Nath Outsourcing Solutions Pvt. Ltd. Full time

Credentialing SMEAbout the Company:Established in 2003,Nath Outsourcing Solutions Pvt. Ltd. (NOS)specializes in end-to-end solutions for theUS Healthcare Industry . Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding ofRevenue Cycle Management (RCM)concepts. With a team of highly skilled professionals, we are committed to delivering excellence through efficient management and consistent client satisfaction.Position Overview:TheCredentialing SME (Subject Matter Expert)will be responsible for overseeing and managing the end-to-end credentialing process for healthcare providers. This role involves handling payer enrollments, revalidations, and contract management while ensuring compliance with regulatory and organizational standards. The ideal candidate will have hands-on experience in provider credentialing and strong team-handling capabilities to drive operational efficiency and accuracy.Key Responsibilities: Manage and oversee the entire provider credentialing and recredentialing process. Ensure accuracy and completeness of applications and supporting documentation. Coordinate with payers, providers, and internal stakeholders to resolve credentialing-related issues. Maintain up-to-date records and databases for all credentialing activities. Monitor credentialing timelines to ensure compliance with payer requirements. Review and validate work performed by the credentialing team to maintain quality standards. Mentor, guide, and manage a team of credentialing associates to ensure timely deliverables and performance excellence. Prepare reports and metrics related to credentialing operations for leadership review. Qualifications: Graduation in any discipline. Minimum 3 years of experiencein US Healthcare Credentialing, includingteam handling experience . Strong knowledge of payer enrollment processes, CAQH, NPPES, PECOS, and other credentialing systems. Excellent communication and leadership skills. Preferred Age Group: 25 to 35 years old. Shift Timings: Night Shift (6:00 PM IST to 3:00 AM IST) Working Days: 5 Days (Monday – Friday) Location: Plot No: I-48, Sector 83, Alpha IT City, Mohali 160055 Email ID: hanand@nath-mds.com , Team-HR@nath-mds.com

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