QA Credentialing / Provider Enrollment / Quality Audit

Getix Health; Bengaluru; On-site; INR 600,000 - 900,000; Full time

Job summary

Getix Health in Bengaluru (Embassy Tech Village) is seeking an experienced Quality Analyst Credentialing with strong knowledge of US healthcare and provider credentialing processes. You will perform quality audits, review cases for accuracy, and ensure compliance with client SOPs.

Ideal candidates have hands-on credentialing operations experience, strong analytical and communication skills, and a track record of identifying errors and driving quality improvements in credentialing and CAQH

Qualifications

• Hands-on experience in US healthcare credentialing and quality auditing.
• Ability to identify errors, analyze trends and provide feedback.
• Strong knowledge of CAQH and credentialing verification processes.
• Excellent analytical, problem-solving and attention to detail.

Responsibilities

• Perform quality audits for Provider Credentialing processes.
• Review credentialing cases for accuracy, completeness, and quality standards.
• Validate provider information and supporting documentation.
• Audit initial credentialing and re-credentialing activities.
• Identify process gaps, errors and recurring quality issues.
• Conduct root-cause analysis and recommend corrective actions.
• Provide constructive feedback to associates and support quality improvement.
• Monitor process adherence and ensure client SOPs are followed.
• Prepare quality reports, audit findings and documentation.
• Coordinate with Operations, SMEs and Training teams to improve quality.

Skills

US Healthcare / RCM

Provider Credentialing

Quality Auditing / Quality Assurance

CAQH and credentialing verification

Analytical thinking

Attention to detail

Verbal and written communication

Error identification & feedback

Job description

We are looking for an experienced Quality Analyst Credentialing with strong knowledge of US Healthcare and provider credentialing processes. The ideal candidate should have hands‑on experience in credentialing operations along with quality auditing, process compliance, error identification, and feedback.

Key Responsibilities

• Perform quality audits for Provider Credentialing processes.
• Review credentialing cases for accuracy, completeness, and adherence to defined quality standards.
• Validate provider information and supporting documentation.
• Audit activities related to initial credentialing and re‑credentialing.
• Identify process gaps, errors, and recurring quality issues.
• Conduct root‑cause analysis and recommend corrective/preventive actions.
• Provide constructive feedback to associates and support quality improvement initiatives.
• Monitor process adherence and ensure compliance with client requirements and internal SOPs.
• Prepare and maintain quality reports, audit findings, and relevant documentation.
• Coordinate with Operations, SMEs, and Training teams to improve process quality.

Required Skills

• Good knowledge of US Healthcare / RCM.
• Strong understanding of Provider Credentialing processes.
• Experience in Quality Auditing / Quality Assurance.
• Knowledge of CAQH and credentialing verification processes is preferred.
• Good analytical and problem‑solving skills.
• Strong attention to detail.
• Good verbal and written communication skills.
• Ability to identify errors, analyze trends, and provide effective feedback.

Preferred Candidate Profile

• Relevant experience in US Healthcare Credentialing.
• Prior experience as a Quality Analyst/Quality Auditor in Credentialing preferred.
• Candidates with a combination of credentialing process knowledge and auditing experience will be preferred.

(Immediate joiners preferred)

Job Location: Bengaluru (Embassy Tech Village)

Shift: Night Shift (5:30pm to 2:20am)