Credentialing Specialist

Getixhealth-India; Karnataka; On-site; INR 600,000 - 900,000; Full time

Job summary

Getixhealth-India seeks a Credentialing Specialist in Karnataka to manage provider enrollment across US payer networks. You will verify credentials, complete CAQH profiles, track enrollments, handle document requests, and maintain detailed logs.

This role requires CAQH knowledge, Medicare/Medicaid familiarity, strong communication, and the ability to manage multiple tasks while meeting deadlines.

Qualifications

• Knowledge of US Healthcare Credentialing and Provider Enrollment.
• Experience with CAQH, Medicare, Medicaid, and Commercial Payers.
• Strong communication and interpersonal skills.
• Good analytical and problem-solving abilities.
• Proficiency in MS Office, especially Excel.
• Ability to manage multiple tasks and meet deadlines.
• Excellent documentation and follow-up skills.

Responsibilities

• Contact insurance payers to verify credentialing and enrollment status.
• Follow up on pending credentialing and re-credentialing applications.
• Communicate with providers regarding missing documents and application updates.
• Resolve credentialing-related issues through phone calls and emails.
• Maintain detailed call logs and updates in the credentialing system.
• Coordinate with insurance representatives to expedite applications.
• Process provider credentialing and enrollment applications.
• Complete CAQH profile updates and attestations.
• Prepare, submit, and track payer enrollment requests.
• Maintain provider files, licenses, certifications, and supporting documents.
• Monitor credentialing expirations and ensure timely renewals.
• Handle email communication with providers and payers.
• Update credentialing databases and generate status reports.

Skills

US healthcare credentialing

CAQH, Medicare & Medicaid

Communication skills

Analytical & problem solving

MS Office (Excel)

multitasking & deadline management

Documentation & follow-up

Job description

• Contact insurance payers to verify credentialing and enrollment status.
• Follow up on pending credentialing and re-credentialing applications.
• Communicate with providers regarding missing documents and application updates.
• Resolve credentialing-related issues through phone calls and emails.
• Maintain detailed call logs and updates in the credentialing system.
• Coordinate with insurance representatives to expedite applications.
• Process provider credentialing and enrollment applications.
• Complete CAQH profile updates and attestations.
• Prepare, submit, and track payer enrollment requests.
• Maintain provider files, licenses, certifications, and supporting documents.
• Monitor credentialing expirations and ensure timely renewals.
• Handle email communication with providers and payers.
• Update credentialing databases and generate status reports.

Required Skills

• Knowledge of US Healthcare Credentialing and Provider Enrollment.
• Experience with CAQH, Medicare, Medicaid, and Commercial Payers.
• Strong communication and interpersonal skills.
• Good analytical and problem-solving abilities.
• Proficiency in MS Office, especially Excel.
• Ability to manage multiple tasks and meet deadlines.
• Excellent documentation and follow-up skills.