Credentialing SME

Credentialing SME

About the Company:

Established in 2003,
Nath Outsourcing Solutions Pvt. Ltd. (NOS)
specializes in end-to-end solutions for the
US Healthcare Industry
. Our expertise spans managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding of
Revenue Cycle Management (RCM)
concepts. With a team of highly skilled professionals, we are committed to delivering excellence through efficient management and consistent client satisfaction.

Position Overview:

The
Credentialing SME (Subject Matter Expert)
will be responsible for overseeing and managing the end-to-end credentialing process for healthcare providers. This role involves handling payer enrollments, revalidations, and contract management while ensuring compliance with regulatory and organizational standards. The ideal candidate will have hands-on experience in provider credentialing and strong team-handling capabilities to drive operational efficiency and accuracy.

Key Responsibilities:

• Manage and oversee the entire provider credentialing and recredentialing process.
• Ensure accuracy and completeness of applications and supporting documentation.
• Coordinate with payers, providers, and internal stakeholders to resolve credentialing-related issues.
• Maintain up-to-date records and databases for all credentialing activities.
• Monitor credentialing timelines to ensure compliance with payer requirements.
• Review and validate work performed by the credentialing team to maintain quality standards.
• Mentor, guide, and manage a team of credentialing associates to ensure timely deliverables and performance excellence.
• Prepare reports and metrics related to credentialing operations for leadership review.

Qualifications:

• Graduation in any discipline.
• Minimum 3 years of experience
  in US Healthcare Credentialing, including
  team handling experience
  .
• Strong knowledge of payer enrollment processes, CAQH, NPPES, PECOS, and other credentialing systems.
• Excellent communication and leadership skills.

Preferred Age Group:

• 25 to 35 years old.

Shift Timings:

• Night Shift (6:00 PM IST to 3:00 AM IST)

Working Days:

• 5 Days (Monday – Friday)

Location:

Plot No: I-48, Sector 83, Alpha IT City, Mohali 160055

Email ID:

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