Credentialing Process Expert

3 days ago

Chennai, Tamil Nadu, India MINDTEL GLOBAL Full time ₹ 5,00,000 - ₹ 12,00,000 per year

Industry & Sector:
A technology-enabled healthcare provider services and healthcare BPO organisation operating across payer and provider networks. We support provider enrollment, network management, and regulatory compliance for healthcare customers across India. This on-site role is based in India and focuses on operational excellence in credentialing processes.

Standardized Title:
Provider Credentialing Specialist (Credentialing Process Expert)

Role & Responsibilities

  • Manage end-to-end provider credentialing lifecycle—collect, validate, and maintain credentialing packets and provider documentation to ensure timely enrollment and network participation.
  • Perform primary source verification (PSV) for licensure, education, board certification, DEA, and work history; document results and maintain audit-ready records in credentialing systems.
  • Prepare and submit enrollment and re-credentialing applications to CAQH, PECOS, state Medicaid, and commercial payers; monitor application status and resolve payer requests or deficiencies.
  • Maintain and reconcile provider data across directories and databases (NPI, TIN, specialty, rosters); update credentialing platforms and internal systems for accuracy.
  • Track expirations, alerts, and compliance requirements; coordinate renewals and remediation to prevent gaps in provider billing or network access.
  • Collaborate with provider relations, compliance, HR, and operations to implement process improvements, support audits, and meet NCQA/TJC readiness requirements.

Skills & Qualifications
Must-Have

  • Proven experience managing provider credentialing and enrollment processes, including re-credentialing and primary source verification.
  • Hands-on familiarity with CAQH ProView and PECOS payer portals.
  • Experience using credentialing systems and maintaining provider databases (e.g., Cactus, symplr or equivalent).
  • Strong working knowledge of NPI registry, state Medicaid enrollment, and payer-specific enrollment requirements.

Preferred

  • Understanding of NCQA/TJC standards and audit-readiness practices for credentialing.
  • Experience with verification vendors (e.g., Verisys) or advanced Excel / reporting skills for credentialing metrics and SLAs.

Benefits & Culture Highlights

  • On-site team environment with structured career paths in provider services and healthcare operations.
  • Opportunities for upskilling in payer enrollment platforms and compliance frameworks.
  • Competitive compensation, performance-linked incentives, and focus on operational excellence.

Location: On-site in India. If you are a meticulous operator with deep credentialing knowledge and a drive to streamline provider onboarding at scale, this role offers high impact and visibility across provider and payer engagements.

Skills: credentialing,payer,compliance,databases,operational excellence,microsoft excel,healthcare

  • Credentialing Executive

    3 days ago

    Chennai, Tamil Nadu, India Al Fahad Full time ₹ 3,60,000 - ₹ 7,20,000 per year

    Job Title: Healthcare Credentialing Executive (Provider Side)Location: ChennaiSalary: Up to ₹6 LPAExperience Required: Minimum 2 YearsQualification: Bachelor's Degree or HSCJob Summary:We are seeking an experienced Healthcare Credentialing Executive to manage and maintain the credentialing process for healthcare providers. The ideal candidate will have...

  • Team Lead, Credentialing

    1 day ago

    Chennai, Tamil Nadu, India Assured Full time ₹ 12,00,000 - ₹ 36,00,000 per year

    OverviewThe Credentialing Team Lead is responsible for managing and overseeing the day-to-day operations of the Credentialing department. This role ensures compliance with U.S. federal and state regulations, as well as organizational policies and procedures while leading a team of Operations Associates (i.e. credentialing...

  • Credentialing Specialist(Provider Side)

    5 days ago

    Chennai, Tamil Nadu, India Anicut Healthcare Solutions Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Job descriptionCredentialing Specialist(Provider Side)We are looking for a Experienced Credentialing Specialist(Provider Side) to join our medical billing team for the Mid shift. The ideal candidate will have 1-4 years of experience in medical billing with a strong focus on Credentialing Process(Provider Side).Job Role: Credentialing Enrollment(Provider...

  • Hiring For Credentialing experienced candidate @ Omega

    2 weeks ago

    Chennai, Tamil Nadu, India Omega Healthcare Full time ₹ 6,00,000 - ₹ 12,00,000 per year

    Role & responsibilitiesShould have experience in Credentialing process in Medical Billing - Min of 1 year to Max 6 years.Credentialing in medical billing is the process that all healthcare service providers perform to become enlisted with insurance companies. Only trusted, vetted, and verified insurance companies include healthcare providers to serve their...

  • Hiring Manager-Credentialing and ATL

    22 hours ago

    Chennai, Tamil Nadu, India Healthrecon Connect Full time ₹ 12,00,000 - ₹ 36,00,000 per year

    "HealthRecon Connect LLC provides technology-enabled Revenue Cycle Management (RCM) solutions to US healthcare providers. We leverage over 30 years of deep domain expertise, cutting-edge analytics as well as machine learning, Artificial Intelligence and Automated workflows to help improve cashflow, patient outcomes and enable peace of mind for our clients.We...

  • Opening - Credentialing | US Healthcare | Night Shift

    1 day ago

    Chennai, Tamil Nadu, India Novigo Integrated Services Full time ₹ 2,00,000 - ₹ 4,00,000 per year

    Dear Aspirants,Warm GreetingsWe are hiring for the following details,Position:-Credentialing ( Voice Process -Night Shift)Salary: Based on Performance & ExperiencedExp : Min 1 year RequiredJoining: Immediate Joiner / Maximum 10 daysNB: Freshers do not applyWork from office only(Direct Walkins Only)Monday to Friday ( 5 pm to 8 Pm ) Everydaycontact...

  • SAP Process Expert

    2 weeks ago

    Chennai, Tamil Nadu, India, Tamil Nadu Tata Consultancy Services Full time

    Greetings from TCS HR TeamWe are Looking for experienced SAP Process Expert to join our dynamic team. This role involves working with global clients, understanding their business processes, and delivering innovative SAP Solutions.Over 10 years of experience in SAP implementation.In-depth understanding of business processes in functional areas such as...

  • Senior Process Expert

    3 days ago

    Chennai, Tamil Nadu, India A.P. Moller - Maersk Full time US$ 60,000 - US$ 80,000 per year

    About Maersk: Maersk is a global leader in integrated logistics with a rich history of over a century, dedicated to setting new standards in efficiency, sustainability, and excellence. With a presence in 130 countries and a diverse workforce of over 100,000 employees, we shape the future of global trade and logistics through innovation and...

  • Process Expert

    1 week ago

    Chennai, Tamil Nadu, India A.P. Moller - Maersk Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    Has responsibility for handling daily Documentation tasks in line withthe Client/Process IOP's and ensures quality of service is maintained atall times.May support peers with technical or process related challenges duringprocess executionHas accountability for preparation of export/import documentation and submission of the same timely and accurately to...

  • Process Expert

    3 days ago

    Chennai, Tamil Nadu, India A.P. Moller - Maersk Full time ₹ 9,00,000 - ₹ 12,00,000 per year

    We OfferAs an employee with Maersk GSC you will be part of a working environment as diverse as the APMM group. Maersk strongly encourages continuous learning at work and sharing of best practices by rewarding innovations. We aren't all about work, we believe in a holistic development of our employees and so regularly organize recreational activities giving...