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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