Credentialing Specialist, Contracts

Nimble; Hyderabad; On-site; INR 450,000 - 650,000; Full time

Job summary

Nimble is seeking a Credentialing Specialist in Hyderabad to manage end-to-end provider and facility credentialing for multiple client accounts. You will prepare enrollment applications, verify licenses and credentials, and maintain audit-ready records across systems.

Strong knowledge of Medicare, Medicaid, and commercial payers is essential. The role requires hands-on experience with PECOS, CAQH, NPPES, and payer portals, plus excellent communication and organizational skills for timely

Qualifications

• Minimum 2 years of provider credentialing and payer enrollment experience.
• Strong knowledge of Medicare, Medicaid, and commercial payer processes.
• Hands-on experience with PECOS, CAQH, NPPES, and payer portals.
• Facility credentialing experience is a significant advantage.
• Excellent organizational and documentation skills; detail oriented.

Responsibilities

• Manage end-to-end provider and facility credentialing and recredentialing for client accounts.
• Prepare, submit, track, and maintain payer enrollment applications for Medicare, Medicaid, and major payers.
• Verify licenses, NPI, DEA, malpractice coverage, CAQH profiles and other docs.
• Maintain audit-ready credentialing records in databases and client systems.
• Monitor status and follow up with payers to minimize delays.
• Communicate with providers, facilities, payers, and stakeholders to resolve issues.
• Renewals: monitor expirations and initiate renewals to ensure participation.
• Collaborate with Contracting, RCM, Billing to align credentialing with contracts.
• Provide regular credentialing status reports with updates on pending/approved items.
• Stay current with CMS and payer requirements and NCQA standards.

Skills

Credentialing

Healthcare administration

Attention to detail

Communication

Multitasking

Education

Bachelor's degree or Associate's degree in healthcare/related field

Tools

PECOS

CAQH

NPPES

Payer portals

Credentialing software

Job description

Responsibilities

• Manage end-to-end provider and facility credentialing and recredentialing processes for assigned client accounts.
• Prepare, submit, track, and maintain payer enrollment and participation applications for Medicare, Medicaid, and all major commercial payers.
• Verify provider and facility credentials, including state licenses, NPI, DEA, malpractice coverage, CAQH profiles, board certifications, accreditations,and other required documentation.
• Maintain accurate, organized, and audit-ready credentialing records within internal databases, payer portals, and client systems.
• Monitor application status and perform timely follow-ups with payers to ensure prompt approvals and minimize enrollment delays.
• Communicate effectively with providers, facilities, payers, and internal stakeholders to resolve credentialing and enrollment issues.
• Proactively monitor upcoming expirations and initiate renewals to ensure uninterrupted provider and facility participation in payer networks.
• Collaborate with Contracting, Revenue Cycle Management (RCM), and Billing teams to align credentialing activities with payer contracts and claim submission readiness.
• Prepare and share regular credentialing and enrollment status reports with clients, providing accurate updates on pending, approved, and outstanding items.
• Stay current with CMS regulations, Medicare and Medicaid guidelines, NCQA standards, and commercial payer credentialing requirements to ensure compliance.

Requirements

Qualifications

• Associate's or Bachelor's degree preferred, preferably in Healthcare Administration, Business Administration, or a related field.
• Minimum 2 years of provider credentialing and payer enrollment experience, preferably within an RCM vendor, healthcare organization, or multi-client environment.
• Strong knowledge of Medicare, Medicaid, and commercial payer credentialing and enrollment processes.
• Hands-on experience with PECOS, CAQH, NPPES, payer portals, and credentialing/enrollment software.
• Facility credentialing experience is highly preferred and will be considered a Significant advantage.
• Strong understanding of provider and facility enrollment requirements for government and commercial health plans.
• Excellent organizational, documentation, and analytical skills with strong attention to detail.
• Ability to manage multiple client accounts, priorities, and deadlines simultaneously.
• Strong typing skills with the ability to maintain accurate and timely documentation.
• Excellent verbal and written communication skills, including the ability to professionally communicate with clients, providers, facilities, and payer representatives.
• Ability to independently prepare and present client status updates and credentialing progress reports.
• Proficiency in Microsoft Office Suite, including Excel, Word, Outlook, and credentialing management systems.

Preferred Skills

• Expertise in both Provider and Facility Credentialing.
• Strong working knowledge of Medicare, Medicaid, and all major commercial payers.
• Experience managing credentialing activities across multiple clients and payer networks.
• Client-facing experience with status reporting and stakeholder communication.

Ability to identify, troubleshoot, and resolve credentialing and enrollment issues