Insurance Credentialing Specialist

6 days ago

Bengaluru, Karnataka, India Total RCM Solutions Full time US$ 40,000 - US$ 80,000 per year

Company Overview

Total RCM Solutions is a premier revenue cycle management firm assisting healthcare providers across the USA. Established in 2018, our team collectively boasts over 100 years of expertise, offering tailored services that optimize practice operations. From comprehensive revenue cycle management to individualized solutions, we ensure adherence to coding guidelines and provide multilingual patient support, serving both healthcare entities and other RCM firms.

Job Overview

This full-time, hybrid role based in Bengaluru offers a mid-level position as an Insurance Credentialing Specialist. The successful candidate will have 4 to 6 years of experience in the field of credentialing. You will be responsible for managing provider enrollments, handling credentialing processes, and maintaining high attention to detail. The role requires strong expertise in CAQH management and provider enrollment.

Qualifications and Skills

  • Extensive experience in CAQH Management ensuring timely and accurate credentialing of healthcare providers (Mandatory skill).
  • Proficiency in Provider Enrollment processes to facilitate smooth onboarding of new practitioners (Mandatory skill).
  • Strong Attention to Detail to maintain and update provider information accurately (Mandatory skill).
  • Experience in Medicare/Medicaid Credentialing, ensuring compliance with all relevant regulations.
  • Knowledge in Insurance Verification, adept at confirming coverage and mitigating potential issues.
  • Proven abilities in Payer Contracting, negotiating terms that benefit both providers and the company.
  • Hands-on familiarity with Credentialing Software to streamline and automate processes efficiently.
  • Demonstrated ability to collaborate effectively within a team to drive successful credentialing outcomes.
  • Exceptional communication skills to engage with external partners and internal teams effectively.

Roles and Responsibilities

  • Manage and oversee the entire credentialing process for healthcare providers, ensuring compliance with payor regulations.
  • Coordinate provider enrollment applications and maintain swift processing times for new enrollments.
  • Collaborate with insurance companies and medical facilities to uphold high standards in credentialing.
  • Ensure all provider data in CAQH and various systems is up-to-date and accurate.
  • Address and resolve discrepancies or issues during the credentialing process in a timely manner.
  • Liaise with insurance payers for efficient contract negotiations and relationship management.
  • Work closely with cross-functional teams to ensure seamless workflow integration.
  • Stay informed on current industry practices and updates to maintain compliance and best practices.

  • Insurance Credentialing Specialist

    4 hours ago

    Bengaluru, Karnataka, India Total RCM Solutions Full time ₹ 4,00,000 - ₹ 12,00,000 per year

    Company OverviewTotal RCM Solutions is a leading revenue cycle management company serving healthcare providers in the US. With a focus on tailored processes, robust expertise, and comprehensive support services, we deliver innovative medical billing and back-office solutions, backed by a team with over 100 years of industry experience. Learn more at Job...

  • Credentialing Specialist

    1 week ago

    Bengaluru, Karnataka, India Flatworld Healthcare Services Private Limited Full time ₹ 14,40,000 - ₹ 18,00,000 per year

    Dear All,Greetings from Flatworld Healthcare Services.WE ARE HIRING Job Title: Credentialing & Provider Enrollment SpecialistDepartment: Revenue Cycle Management (RCM)Experience Required: 1 to 5 YearsLocation: BangaloreEmployment Type: Full-timeInterested candidates can share their CVs at or contact Available between 1 PM - 10 PM).Job Summary:We are seeking...

  • Credentialing Specialist

    6 days ago

    Bengaluru, Karnataka, India Total RCM Solutions Full time ₹ 40,00,000 - ₹ 80,00,000 per year

    Company OverviewTotal RCM Solutions is a leading revenue cycle management company serving healthcare providers across the USA. With over 100+ years of combined expertise, the company offers comprehensive end-to-end RCM services and specialized solutions, including appeal management and patient services. Headquartered in Bangalore, Total RCM Solutions is...

  • Credentialing Specialist

    6 days ago

    Bengaluru, Karnataka, India Omega Healthcare Full time

    Role & responsibilitiesKey Responsibilities:Prepare, review, and submit credentialing and re-credentialing applications for healthcare providers.Coordinate with insurance companies, medical groups, and clients to ensure timely enrollment.Maintain credentialing databases and track the status of applications.Communicate with clients and providers to resolve...

  • Credentialing/Provider Enrollment Specialist

    4 days ago

    Bengaluru, Karnataka, India Finnastra Full time ₹ 6,00,000 - ₹ 12,00,000 per year

    Company DescriptionFounded in 2010 and headquartered in Bengaluru, Finnastra is a technology-driven B2B solutions provider specializing in Revenue Cycle Management (RCM), Credentialing, Corporate Finance, and PM & EHR Software. We empower healthcare providers, payers, and credentialing organizations to optimize financial performance and streamline operations...

  • Director of Credentialing

    3 hours ago

    Bengaluru, Karnataka, India Plutus Health Inc. Full time ₹ 35,00,000 - ₹ 45,00,000 per year

    ABOUT PLUTUS HEALTHPlutus Health is a Dallas-headquartered healthcare revenue cycle management company serving providers across multiple specialties. With 1,600+ employees in the United States, India, and the Philippines, we deliver end-to-end RCM services including medical billing, credentialing, payer enrollment, and contracting.POSITION OVERVIEWThe...

  • Credentialing Specialist

    2 weeks ago

    Bengaluru, Karnataka, India GetixHealth Full time ₹ 6,00,000 - ₹ 12,00,000 per year

    Job DetailsDescriptionContinual development to be an expert with knowledge of respective clients Credentialing specialties.Report any system downtime to respective Supervisors and manage the work in such situations.persuasively; provides clarification; responds well to questions; participates in and contributes to meetings.Follows policies and procedures;...

  • Intern-Credentialing

    1 week ago

    Bengaluru, Karnataka, India Teleradiology Solutions (TRS) Full time ₹ 80,000 - ₹ 1,20,000 per year

    Job InformationIndustryHealth CareDate Opened09/29/2025Job TypeFull timeWork Experience0-1 yearCityBangalore NorthState/ProvinceKarnatakaCountryIndiaZip/Postal Code560048Job DescriptionJob Description-Intern/Credentialing ExecutiveWho are we & what do we do?Teleradiology Solutions was founded in 2002 by two Yale University-trained physicians. We provide...

  • AR - CREDENTIALING (Voice / Semi-Voice Process)

    2 weeks ago

    Bengaluru, Karnataka, India Starworth GLOBAL SOLUTIONS Full time ₹ 4,80,000 - ₹ 7,20,000 per year

    HIRING NOW – CREDENTIALING (Voice / Semi-Voice Process)Location: BangaloreSalary: Up to 40K (Max Slab)Immediate Joiners OnlyRole Overview:Responsible for end-to-end credentialing activities for healthcare providers.Handling voice / semi-voice process for provider data verification and updates.Ensure compliance with payer requirements and timelines.Work...

  • Insurance Verification and Authorization Specialist

    2 weeks ago

    Bengaluru, Karnataka, India Nexgenhiringexperts Full time ₹ 40,00,000 - ₹ 1,20,00,000 per year

    Job Title: Insurance Verification and Authorization SpecialistPosition Type: Full-TimeLocation: Remote (Flexible hours with some work during US Central Time Zone and regular India business hours)Experience Required: Minimum 2 yearsJob Description:We are looking for an experienced Insurance Verification and Authorization Specialist to join our team. This...