CREDENTIAL SPECIALIST

Job Title
Credentialing Specialist
Job Description
Credentialing Specialist will work with the credentialing team in the United Statesto help physicians,
medical practices, and healthcare organizations with credentialing and enrollment. The roles and
responsibilities include:
• Track and follow up with providers for timely return of all required credentialing documents and
applications
• Assist in synchronization of data among multiple systems
• Maintain credentialing database and ensure up-to-date tracking of application process
• Document progress in project management software, and provide regular updates to management
• Work with commercial and governmental payers for credentialing and enrolment of multiple
provider specialties and facility types
• Stay up to date on licensing, verification, and state specific rules and bylaws to maintain compliance
• Display in depth knowledge of and execution of all standard operating procedures (SOP’s) as well as
communicating issues, trends, concerns, and suggestions to management
• Perform other duties as assigned
Job Requirements
• Strong knowledge of the US healthcare landscape
• Basic medical billing and payer network skillset required
• Thorough knowledge of CAQH, with ability to document and prepare applications for healthcare
providers
• Intermediate knowledge of provider hospital credentialing and hospital admitting privileges
• Ability to plan, prioritize, and complete work to meet established objectives
• Highly proficient with computers, especially Word and Excel
• Excellent written and oral English communication skills
• Positive attitude and an outgoing personality
• Ability to work night shifts
Experience: More than 1 years’ experience in provider credentialing and enrolment
Qualification: B.E. / B. Tech with relevant work experience required
Shifts: Night Shift (6:30 pm – 4:00 am) Monday to Friday
Salary: Commensurate with experience