Senior Process Executive (Credential Enrollment)

Cognizant; Hyderabad; On-site; INR 600,000 - 800,000; Full time

Job summary

Cognizant in Hyderabad is seeking a Senior Credentialing/Enrolment Associate to support US healthcare RCM operations focused on provider credentialing. You will manage CAQH profiles, enrollment and recredentialing for physician groups and facilities, ensuring compliance with payer requirements.

Responsibilities include navigating Medicare/Medicaid, BCBS, UHC, and other payers, using Excel and credentialing software, and coordinating with providers and payers to secure timely enrollments.

Qualifications

• 2–5 years of US Healthcare Revenue Cycle Management experience focused on credentialing and enrollment.
• Hands-on with CAQH profile management, provider enrollment and recredentialing.

Responsibilities

• Hands-on experience with CAQH profile management, provider enrollment, recredentialing, and payer enrollment processes.
• Strong knowledge of provider enrollment requirements for Medicare, Medicaid, BCBS, UHC, Aetna, Cigna, Humana, Tricare, and other commercial payers.
• Familiarity with NPI, Tax ID, PECOS, CMS applications, provider contracts, and regulatory requirements.
• Experience working with physician groups, hospitals, and ancillary providers.
• Proficient in Microsoft Excel, payer portals, and credentialing software/tools.
• Strong communication, analytical, organizational, and follow-up skills

Skills

CAQH profile management

Provider enrollment

Recredentialing

Payer enrollment processes

NPI

Tax ID

PECOS

CMS applications

Provider contracts

Regulatory requirements

Microsoft Excel

Payer portals

Credentialing software

Communication

Analytical skills

Organizational skills

Follow-up skills

Education

Graduate in any discipline; Life Sciences/Healthcare Administration preferred

Tools

Microsoft Excel

Payer portals

Credentialing software

CMS applications

PECOS

NPI

Tax ID

Provider contracts

Job description

Job Description

SPE - Voice

Senior Credentialing/Enrolment Associate

Qualification

• Graduate in any discipline; Life Sciences, Healthcare Administration, or related field preferred.


• 2-5 years of experience in US Healthcare Revenue Cycle Management (RCM) with a focus on Provider Credentialing and Enrollment.

Roles and Responsibilities

• Hands-on experience with CAQH profile management, provider enrollment, recredentialing, and payer enrollment processes.


• Strong knowledge of provider enrollment requirements for Medicare, Medicaid, BCBS, UHC, Aetna, Cigna, Humana, Tricare, and other commercial payers.


• Familiarity with NPI, Tax ID, PECOS, CMS applications, provider contracts, and regulatory requirements.


• Experience working with physician groups, hospitals, and ancillary providers.


• Proficient in Microsoft Excel, payer portals, and credentialing software/tools.


• Strong communication, analytical, organizational, and follow-up skills