Credentialing Process Expert

5 days ago

Chennai India GLOBELANCE Full time

Job Description About The Opportunity We operate in the Healthcare BPO sector, providing provider enrollment, credentialing, and network management services to payers, hospitals, and clinical networks. Our teams ensure provider data integrity, regulatory compliance, and timely network access for clinicians across multiple specialties. Role: Provider Credentialing Specialist (Night Shift) On-site (India) | Hiring company: Globelance Role & Responsibilities - Perform end-to-end credentialing and re-credentialing activities for providers, including application processing, primary source verification (PSV), and CAQH record maintenance during night shifts. - Submit and track provider enrollment applications with payers, IPAs, hospitals, and state licensing boards; follow up to resolve outstanding requirements and expedite approvals. - Validate licensure, board certifications, malpractice history, work history, and sanctions; document findings and escalate discrepancies per SOPs. - Maintain and update credentialing databases and credentialing software (e.g., CredentialStream, Symplr); ensure files are audit-ready and compliant with NCQA/URAC standards. - Coordinate with providers, credentialing managers, and internal teams to request missing documents, schedule verifications, and close open items within SLA. - Support quality assurance and audit activities: prepare reports, reconcile provider rosters, monitor expiries, and trigger renewals to avoid network gaps. Skills & Qualifications Must-Have - CAQH ProView - Primary Source Verification - CredentialStream - Symplr - NCQA standards - HIPAA compliance - Microsoft Excel - EHR/EMR systems Preferred - Certified Provider Credentialing Specialist (CPCS) - Experience with payer enrollment portals - Audit and quality assurance in credentialing Benefits & Culture Highlights - On-site night-shift role with competitive shift differential and structured training for career growth in healthcare operations. - Hands-on exposure to enterprise credentialing platforms and compliance frameworksideal for candidates seeking specialization in provider network management. - Collaborative, process-driven environment with opportunities to contribute to SOP improvements and audit-readiness initiatives. Location: On-site, India (night shift). We encourage high-attention-to-detail candidates with strong process discipline and experience in provider credentialing to apply. Globelance is an equal-opportunity employer committed to a diverse and inclusive workforce. Skills: credentialing,communication,management,quality assurance,compliance,microsoft excel,healthcare

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