Credentialing Specialist

Neolytix; Gurugram District; On-site; INR 900,000 - 1,300,000; Full time

Job summary

Neolytix in Gurugram seeks an experienced Credentialing Team Leader to manage end-to-end provider credentialing and insurance contracting for US clients.

You will oversee CAQH, PECOS, NPPES, CMS systems, ensure active payer statuses, and guide a credentialing team to deliver accurate records and timely updates.

This role demands strong leadership, attention to detail, and ability to coordinate with clients and billing teams.

Qualifications

• Minimum 5-6 years of experience in end-to-end credentialing.
• Lead or team handling experience preferred.

Responsibilities

• Manage end-to-end credentialing and contracting for providers and groups.
• Ensure providers maintain active status with Medicare, Medicaid, and commercial payers.
• Oversee and update provider information in CAQH, PECOS, NPPES, CMS databases.
• Handle initial credentialing, re-credentialing, and revalidation processes.
• Maintain accurate provider records and internal trackers.
• Coordinate with clients, physicians, and billing teams to resolve issues.
• Track application progress and provide regular updates to clients.
• Ensure compliance with payer requirements and deadlines.
• Lead and guide the credentialing team for quality and efficiency.

Skills

US credentialing

Medicare/Medicaid

CAQH/PECOS/NPPES

CMS systems

Team leadership

Attention to detail

Time management

Excel

Word

Internet tools

Job description

Role Overview

We are looking for an experienced Credentialing Team Leader to manage end-to-end provider credentialing and insurance contracting processes for US healthcare clients.

The ideal candidate will have deep expertise in US healthcare credentialing, strong leadership skills, and the ability to manage teams and client expectations effectively.

Key Responsibilities

• Manage end-to-end credentialing & contracting for providers and groups
• Ensure providers maintain active status with Medicare, Medicaid, and commercial payers
• Oversee and update provider information in CAQH, PECOS, NPPES, CMS databases
• Handle initial credentialing, re-credentialing, and revalidation processes
• Maintain accurate provider records and internal trackers
• Coordinate with clients, physicians, and billing teams to resolve issues
• Track application progress and provide regular updates to clients
• Ensure compliance with payer requirements and deadlines
• Lead and guide the credentialing team for quality and efficiency

Key Skills & Competencies

• Strong knowledge of US provider credentialing and insurance contracting
• Hands-on experience with Medicare, Medicaid, and commercial payers
• Expertise in CAQH, PECOS, NPPES, CMS systems
• Excellent team management & communication skills
• Strong attention to detail and organizational abilities
• Ability to prioritize tasks and meet deadlines
• Advanced proficiency in Excel, Word, and internet tools

Experience Required

• Minimum 5-6years of experience in end-to-end credentialing
• Prior experience in a lead or team handling role preferred