Medical Provider Credentialing Professional

4 days ago

Mumbai, Maharashtra, India beBeeCredentialing Full time ₹ 8,00,000 - ₹ 10,00,000
**Credentialing Specialist Role Overview**
Are you a skilled professional with expertise in credentialing and payer relations? We are seeking a highly organized and detail-oriented Credentialing Specialist to join our team.

As a key member of our organization, the successful candidate will be responsible for managing the end-to-end credentialing and re-credentialing process for providers with Medicare, Medicaid, and major commercial insurance payers. This role requires strong communication, documentation, and organizational skills to maintain and update CAQH profiles, NPPES, PECOS, Availity, and other portals with accurate provider information.

Responsibilities:
  • 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.
  • Maintain strict confidentiality of all records, data, and occurrences as a condition of initial and/or continued employment.

Requirements:
  • 2–4 years of payer credentialing experience in an RCM, MSO, or medical group setting.
  • Comprehensive understanding of federal payer systems (Medicare/PECOS, Medicaid) and major commercial payers.
  • Proficiency with credentialing platforms and payer portals (CAQH, PECOS, NPPES, Availity).

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