Credentialing and Provider Enrollment Specialist - Mumbai - WFO

Medusind; Mumbai; On-site; INR 450,000 - 750,000; Full time

Benefits offered by this job

5 Days Working

Two-way cab facility

Job summary

Medusind Solutions in Mumbai invites a credentialing specialist to join the night shift. You will manage end-to-end provider credentialing and enrollment with insurance payers, ensuring timely reimbursements and accurate provider records.

Responsibilities include verifying NPI/CAQH/state licenses/DEA, maintaining data in payer portals, tracking applications, and coordinating with the AR team to resolve denials related to credentialing delays.

Qualifications

• 1 to 4 years of experience in credentialing and provider enrollment (Freshers not eligible)

Responsibilities

• Handle end-to-end provider credentialing and re-credentialing with insurance companies.
• Maintain and update provider data in internal systems and payer portals.
• Verify provider information such as NPI, CAQH, state license, DEA, and malpractice insurance.
• Track credentialing applications and follow up with payers for approval status.
• Collaborate with the AR team to resolve denials or payment issues due to credentialing delays.
• Maintain documentation of all credentialing activities and ensure compliance with payer requirements.
• Communicate with providers and internal teams regarding status updates and missing documentation.
• Support the revenue cycle by ensuring providers are active and eligible with payers for billing.

Skills

Credentialing

Provider enrollment

NPI verification

Data accuracy

Tools

CAQH

Payer portals

Provider data systems

Job description

MEDUSIND SOLUTIONS - Mumbai (WFO)

JOB TITLE - Credentialing and Enrollment

JOB DESCRIPTION:

Managing provider enrollment and credentialing processes with insurance payers to ensure accurate and timely reimbursements. This role involves close coordination with providers, insurance carriers, and internal teams to maintain up-to-date credentials and minimize claim denials related to credentialing issues.

ELIGIBILITY CRITERIA: 1 to 4 Years of Experience in Credentialing and Provider Enrollment (Freshers - Not Eligible)

ROLES AND RESPONSIBILITIES:

• Handle end-to‑end provider credentialing and re‑credentialing with insurance companies.
• Maintain and update provider data in internal systems and payer portals.
• Verify provider information such as NPI, CAQH, state license, DEA, and malpractice insurance.
• Track credentialing applications and follow up with payers for approval status.
• Collaborate with the AR (Accounts Receivable) team to resolve denials or payment issues due to credentialing delays.
• Maintain documentation of all credentialing activities and ensure compliance with payer requirements.
• Communicate with providers and internal teams regarding status updates and missing documentation.
• Support the revenue cycle by ensuring providers are active and eligible with payers for billing.

SHIFT TIMINGS: Night Shift

8:00 PM to 5:00 AM

BENEFITS:

5 Days Working (Saturday & Sunday - Fixed Off)

Salary - Best in Industry

Two way cab facility - (Up to 25km Radius)