Credentialing Specialist

r3 Consultant; Maharashtra; On-site; INR 540,000 - 660,000; Full time

Benefits offered by this job

Competitive salary based on experience

Ongoing professional development

Supportive team culture

Job summary

r3 Consultant is seeking a Credentialing Specialist in Hinjewadi, Pune, responsible for managing and maintaining records of healthcare providers' credentials and ensuring compliance with regulatory standards.

The ideal candidate will have 1 to 5 years of experience in credentialing or healthcare administration, strong communication skills, and proficiency in MS Office. A competitive salary of up to ₹6 LPA is offered, along with opportunities for growth and professional development.

Qualifications

• 1 to 5 years of experience in credentialing or healthcare administration.
• Ability to manage multiple tasks simultaneously.

Responsibilities

• Manage and maintain up-to-date records of healthcare providers’ credentials.
• Conduct thorough verification of education, training, experience, and licensure.
• Ensure compliance with NCQA, URAC, and other regulatory requirements.

Skills

Strong understanding of credentialing standards

Excellent communication skills

Attention to detail

Proficiency in MS Office

Education

Bachelor’s degree in any discipline (Healthcare/Administration preferred)

Job description

Job Title: Credentialing Specialist

Experience: 1–5 Years

Location: Hinjewadi, Pune

Salary: Up to ₹6 LPA

Company Overview

We are a growing organization committed to delivering high-quality healthcare solutions. As part of our continued expansion, we are looking for a diligent and detail-oriented Credentialing Specialist to join our team in Hinjewadi, Pune. This role is critical in ensuring compliance with credentialing standards and maintaining a strong provider network.

Key Responsibilities

• Manage and maintain up-to-date records of healthcare providers’ credentials, licenses, certifications, and affiliations.
• Coordinate and process initial credentialing and re-credentialing applications for providers in accordance with company policies and regulatory standards.
• Conduct thorough verification of education, training, experience, and licensure through primary sources.
• Liaise with insurance companies, hospitals, and credentialing bodies to ensure timely approvals.
• Monitor and track expiration dates for licenses and certifications and proactively follow up for renewals.
• Maintain accurate and organized electronic and physical credentialing files.
• Ensure compliance with NCQA, URAC, and other regulatory requirements.
• Prepare and submit credentialing reports for audits and internal use.

Qualifications & Skills

• Bachelor’s degree in any discipline (Healthcare/Administration preferred).
• 1 to 5 years of experience in credentialing or healthcare administration.
• Strong understanding of credentialing standards, healthcare regulations, and compliance.
• Excellent communication and organizational skills.
• High attention to detail and ability to manage multiple tasks simultaneously.
• Proficiency in MS Office (Excel, Word, Outlook) and credentialing software/tools is an added advantage.

What We Offer

• Competitive salary up to ₹6 LPA based on experience and skillset.
• Opportunity to work in a dynamic and growth-oriented environment.
• Supportive team culture and ongoing professional development.