Credentialing Specialist

Ascendum Solutions India

Ahmedabad District

On-site

INR 300,000 - 600,000

Full time

14 days+
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Job summary

Ascendum Solutions India is seeking a Credentialing Support Specialist in Ahmedabad (WFO) to coordinate provider credentialing, recredentialing, and payer enrollment, ensuring regulatory and payer compliance and up-to-date records.

You will collect and organize documentation, perform data entry in CAQH and payer portals, monitor expirations, and support auditing and confidentiality in HIPAA-driven processes, reporting to the credentialing team.

Qualifications

  • Experience with provider credentialing and payer enrollment processes.
  • Familiarity with CAQH, NPI, PECOS and payer portals.
  • HIPAA compliant handling of sensitive information.

Responsibilities

  • Assist with preparation and processing of credentialing and payer enrollment applications.
  • Enter data accurately into credentialing systems, payer portals, and databases.
  • Collect and maintain provider licenses, certifications, malpractice insurance, resumes, and IDs.
  • Follow up with providers to obtain missing credentialing documents.
  • Track outstanding documentation and maintain status reports.
  • Update provider information in CAQH, payer portals, and internal systems.
  • Maintain credentialing files for accuracy and completeness.
  • Monitor expiration dates and assist with renewal reminders.
  • Communicate credentialing requirements and status with providers and team.
  • Audit files and verify documentation; ensure confidentiality per HIPAA.

Skills

Payer enrollment
Credentialing
Document management

Tools

CAQH
NPI
PECOS
Payer portals
Medallion
Paylocity

Job description

Position Title: Credentialing Support Specialist

Location: Ahmedabad (WFO)

Employment Type: Full-Time

Timing: US Shift

Position SummaryThe Credentialing Support Specialist is responsible for coordinating and maintaining all aspects of provider credentialing, recredentialing, and payer enrollment processes. This role ensures providers meet regulatory, accreditation, and payer requirements while maintaining accurate and up-to-date credentialing records. The Credentialing Support Specialist works closely with providers, insurance payers, and internal departments to support timely enrollment and ongoing compliance.Essential Duties and Responsibilities

  • Assist with the preparation and processing of provider credentialing and payer enrollment applications.
  • Perform accurate data entry into credentialing systems, payer portals, spreadsheets, and internal databases.
  • Collect, organize, and maintain provider documentation including licenses, certifications, malpractice insurance, resumes, and identification records.
  • Conduct routine follow-up with providers to obtain missing or updated credentialing documents.
  • Track outstanding documentation requirements and maintain organized status reports.
  • Upload and update provider information in CAQH, payer portals, and internal systems as directed.
  • Support the maintenance of credentialing files to ensure accuracy and completeness.
  • Monitor expiration dates and assist with renewal reminders for licenses, certifications, and payer enrollments.
  • Communicate professionally with providers and internal team members regarding credentialing requirements and status updates.
  • Assist with auditing files and verifying documentation accuracy.
  • Maintain confidentiality and secure handling of provider and company information in compliance with HIPAA and company policies.
  • Perform additional administrative support duties as assigned by the credentialing team.

QualificationsExperience

  • Experience with insurance payer enrollment and provider credentialing processes strongly preferred.
  • Experience working in behavioral health, healthcare, or medical practice settings preferred.

Knowledge, Skills, and Abilities

  • Strong understanding of credentialing and payer enrollment processes.
  • Knowledge of CAQH, NPI, PECOS, and insurance payer portals.
  • Excellent organizational skills and attention to detail.
  • Ability to manage multiple priorities and meet deadlines.
  • Strong written and verbal communication skills.
  • Understanding of Medallion (Credentialing Software) and Paylocity (HRIS)
  • Proficiency with Microsoft Office products
  • Ability to maintain confidentiality and handle sensitive information professionally.
  • Strong problem-solving and follow-up skills.

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