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 Specialist

Department: Revenue Cycle Management (RCM)

Experience Required: 1 to 5 Years

Location: Bangalore

Employment Type: Full-time

Interested candidates can share their CVs at or contact Available between 1 PM - 10 PM).

Job Summary:

We are seeking a detail-oriented and proactive Credentialing & Provider Enrollment Specialist with 1 to 5 years of experience in the healthcare RCM domain. The ideal candidate will be responsible for managing end-to-end provider credentialing, re-credentialing, and enrollment with insurance payers, ensuring compliance with regulatory standards and timelines.

Key Responsibilities:

  • Complete initial and re-credentialing applications for healthcare providers.
  • Submit and track enrollment applications with Medicare, Medicaid, and commercial payers.
  • Maintain and update provider information in internal databases and payer portals.
  • Monitor expirables (licenses, certifications, etc.) and ensure timely renewals.
  • Communicate with providers, payers, and internal teams to resolve enrollment issues.
  • Ensure compliance with payer-specific and regulatory credentialing requirements.
  • Follow up with insurance companies to check application status and resolve delays.
  • Assist in audits and provide necessary documentation as required.

Qualifications:

  • 1 to 5 years of hands-on experience in provider credentialing and enrollment.
  • Knowledge of payer requirements and CAQH, PECOS, NPPES, etc.
  • Strong communication, organizational, and follow-up skills.
  • Proficient in MS Office and credentialing software/tools.

Preferred Skills:

  • Experience working with U.S. healthcare providers.
  • Familiarity with medical billing and insurance guidelines.
  • Ability to manage multiple priorities in a deadline-driven environment.

Perks & Benefits:

  • 5 Days Working
  • Provident Fund & Gratuity
  • Medical Insurance
  • Travel Allowance

Fresher and non-relevant experience applicants, please ignore

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