Medical Credentialing Professional

5 days ago

Mumbai, Maharashtra, India beBeeCredentialing Full time ₹ 9,00,000 - ₹ 12,50,000
Job Summary

We are seeking a skilled Medical Credentialing Professional to join our team. The successful candidate will be responsible for managing the end-to-end credentialing and re-credentialing process for providers with various payers.

Key Responsibilities:
  • Manage provider enrollment applications, group contracts, and facility participation agreements with federal and private payers.
  • Maintain and update CAQH profiles, NPPES, PECOS, Availity, and other portals with accurate provider information.
  • Work closely with payers to ensure credentialing timelines and compliance with state, federal, and payer-specific regulations.
  • Monitor and manage credentialing expirables (e.g., licenses, DEA, malpractice insurance) and ensure timely renewals.
  • Communicate effectively with providers, practice managers, billing teams, and payers to resolve enrollment issues and delays.
Requirements:
  • Strong communication, documentation, and organizational skills.
  • Proficiency in credentialing platforms and payer portals.
  • A comprehensive understanding of federal payer systems (Medicare/PECOS, Medicaid) and major commercial payers.
  • Experience in an RCM, MSO, or medical group setting.
  • Proficiency with Microsoft Office software and knowledge of medical terminology.
Benefits:

This role offers excellent opportunities for professional growth and development. We offer a collaborative and dynamic work environment with a focus on delivering exceptional results.

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