Credentialing Specialist

3 days ago

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

Company Description

GetixHealth partners with healthcare providers across the United States, offering tailored, comprehensive revenue cycle management (RCM) services. We support hospitals, clinics, university medical centers, and other healthcare organizations by optimizing front and back-office processes. Our services include medical coding and billing, claims management, insurance eligibility verification, Medicaid/Medicare support, and self-pay and bad debt collections. At GetixHealth, we strive to enhance operational efficiency and improve financial outcomes for our clients.

Role Description

This is a full-time on-site role for a Credentialing Specialist, located in Bengaluru South. The Credentialing Specialist will handle the end-to-end provider credentialing process, ensuring that healthcare providers meet all compliance requirements. Daily responsibilities include verifying and documenting credentials, managing applications, maintaining up-to-date records, and responding to inquiries from insurance companies and providers. The role also involves liaising with payers to ensure timely claims processing and compliance with current regulatory standards.

Qualifications

  • Experience in credentialing, provider enrollment, and compliance processes
  • Strong proficiency in document management, organization, and data tracking
  • Excellent attention to detail and accuracy in managing sensitive information
  • Proven communication skills for interacting with internal teams and external stakeholders (e.g., providers and payers)
  • Familiarity with healthcare regulations, payer systems, and credentialing software is highly preferred
  • Ability to handle high-volume workloads and manage multiple priorities effectively
  • Bachelor's degree or equivalent experience in healthcare administration, business, or a related field is preferred
  • Knowledge of medical coding or insurance processes is a plus

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