healthcare credentialing specialist

3 weeks ago

Chennai, Tamil Nadu, India Skillra Technologies Full time

About the Role

We are seeking a Healthcare Credentialing Specialist with strong experience in managing provider enrollment, credentialing, and compliance with regulatory guidelines. The ideal candidate will have a keen eye for detail, excellent communication skills, and the ability to work collaboratively with providers, payers, and internal teams.

Key Responsibilities

  • Manage the full-cycle credentialing and re-credentialing process for healthcare providers.
    • Verify and maintain provider documentation, licenses, certifications, and affiliations.
      • Coordinate with insurance companies, hospitals, and healthcare organizations for provider enrollment.
        • Ensure compliance with NCQA, CMS, and other regulatory requirements.
          • Maintain accurate and up-to-date records in credentialing databases.
            • Communicate effectively with providers regarding application status, missing information, or required updates.
              • Support audits, reporting, and quality improvement initiatives.

Qualifications

  • Minimum 1 year of hands-on experience in healthcare credentialing or provider
    • Familiarity with credentialing software/systems (CAQH, NPPES, PECOS, etc.).
      • Excellent organizational and documentation skills.

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