Credentialing Specialist

Rmak Solutions; Mohali; On-site; INR 300,000 - 600,000; Full time

Job summary

Rmak Solutions in Mohali is seeking a Credentialing Specialist to manage end-to-end credentialing for medical providers, ensuring compliance with payer requirements and regulatory standards. You will collect and review licenses, process Medicare panels, and maintain records in internal systems, while communicating updates to stakeholders.

Ideal candidates have experience in US healthcare credentialing, strong communication skills, and proficiency with credentialing systems.

Qualifications

• Experience in US healthcare credentialing.
• Strong credentialing and medical staff credentialing skills for provider enrollment and compliance.
• Effective communication and customer service skills.
• Experience with Medicare and other payer enrollment and re-credentialing processes.
• Attention to detail, strong organizational skills, and ability to manage multiple credentialing files and deadlines.
• Relevant experience in healthcare administration or provider enrollment.
• Knowledge of regulatory standards, licensing processes, and medical terminology.
• Proficiency with office software and credentialing or practice management systems.

Responsibilities

• Manage end-to-end credentialing for medical providers.
• Collect, review, and maintain accurate credentialing documentation.
• Validate licenses and certifications and monitor regulatory compliance.
• Process applications for payer panels such as Medicare.
• Provide status updates and collaborate with providers, payers, and internal teams.
• Support continuous process improvement and quality standards.

Skills

Communication

Customer Service

Attention to detail

Organizational skills

Office software

Credentialing knowledge

Tools

Practice management systems

Job description

Role Description The Credentialing Specialist is a full-time, on-site role based in the Mohali district. This position is responsible for managing the end-to-end credentialing process for medical providers, including collecting, reviewing, and maintaining accurate documentation and ensuring compliance with payer and regulatory requirements. Day-to-day tasks include validating licenses and certifications, processing applications for insurance panels such as Medicare, monitoring credentialing timelines, and maintaining up-to-date records in internal systems. The role involves regular communication with healthcare providers, insurance companies, and internal teams to resolve issues, clarify requirements, and provide status updates. The Credentialing Specialist also supports continuous process improvement, helps ensure that all credentialing activities meet quality and compliance standards, and provides professional customer service to stakeholders.

Qualifications

• EXPERIENCE IN US HEALTHCARE CREDENTIALING
• Candidates should possess strong Credentialing and Medical Staff Credentialing skills for managing provider enrollment and compliance.
• Candidates should possess effective Communication and Customer Service skills to interact with providers, payers, and internal teams professionally.
• Candidates should possess experience with Medicare and other insurance payer requirements to handle enrollment and re-credentialing processes.
• Candidates should possess attention to detail, organizational skills, and the ability to manage multiple credentialing files and deadlines.Relev
• ant experience in healthcare administration, provider enrollment, or a similar credentialing role is beneficial.
• Knowledge of regulatory standards, medical licensing processes, and basic medical terminology is an advantage.
• Proficiency with office software and credentialing or practice management systems is preferred.