Senior Process Executive/ Lead - Provider Credentialing

Amvik Solutions; Chennai; On-site; INR 700,000 - 900,000; Full time

Job summary

Amvik Solutions Pvt. Ltd. in Chennai (Porur) is seeking a Senior Process Executive/Lead - Provider Credentialing to manage end-to-end credentialing activities for physicians and medical groups, including direct interaction with payors, health plans and regulators.

The role requires hands-on enrollment, re-credentialing, due diligence, and compliance with CMS and state guidelines, plus strong verbal communication to coordinate with US stakeholders and maintain accurate credentialing records.

Qualifications

• 6+ years hands-on experience in end-to-end provider credentialing
• Strong working knowledge of CAQH, NPDB, SAM.gov, Medicare and Medicaid
• Excellent verbal communication skills for US voice processes

Responsibilities

• Handle end-to-end provider credentialing and re-credentialing for physicians and medical groups.
• Manage Medicare and Medicaid enrollments, updates, and revalidations.
• Complete and maintain provider profiles across required platforms (CAQH, NPDB, SAM.gov, Medicare/Medicaid portals).
• Coordinate with health plans, payors, and regulatory bodies to track credentialing status.
• Ensure CMS, state, and payor-specific credentialing guidelines are followed; resolve issues and delays.
• Maintain credentialing trackers, status reports, and audit documentation.

Skills

End-to-end credentialing

Verbal communication

Attention to detail

Tools

CAQH

NPDB

SAM.gov

Medicare/Medicaid

Job description

Dear Candidate,

Greetings!

We are looking for a Senior Process Executive / Lead - Provider Credentialing for Amvik Solutions Pvt. Ltd., at our Chennai office in Porur.

Please find the Job description as follows;

Job Title: Senior Process Executive Provider Credentialing

Experience Required: 6+ Years - End-to-End Provider Credentialing

Shift Timing: 4:30 PM 1:30 AM IST

Job Summary:

The Senior Process Executive Voice will be responsible for managing end-to-endprovider credentialing activities, including direct interaction with payors, health plans,and regulatory bodies. The role requires strong hands-on expertise in providerenrollment, re-credentialing, and compliance, along with excellent verbalcommunication skills to handle voice-based coordination with US stakeholders.

Key Responsibilities:

Provider Credentialing & Enrollment• Handle end-to-end provider credentialing and re-credentialing for physiciansand medical groups.• Manage Medicare and Medicaid enrollments, updates, and revalidations.• Complete and maintain provider profiles across all required platforms.
Systems & Databases• Maintain and update provider data in:

• CAQH
• NPDB
• SAM.gov
• Medicare / Medicaid portals
• Ensure accuracy and completeness of all credentialing documentation.Voice & Stakeholder Coordination• Conduct outbound and inbound calls with health plans, payors, and regulatorybodies to follow up on credentialing status.
  • Communicate effectively with providers to collect missing documentation andclarify discrepancies.• Maintain detailed call notes and follow-up trackers.Compliance & Quality• Ensure adherence to CMS, state, and payor-specific credentialing guidelines.• Identify and resolve credentialing issues, discrepancies, and delays.• Maintain high quality standards and meet defined SLAs and TATs.Reporting & Documentation• Maintain credentialing trackers, status reports, and audit documentation.• Support internal audits and compliance reviews as required.

Required Skills & Qualifications:

• 6+ years of hands-on experience in end-to-end provider credentialing
• Strong working knowledge of:
• CAQH
• NPDB
• SAM.gov
• Medicare and Medicaid
• Excellent verbal communication skills for US voice processes.• Strong attention to detail and documentation accuracy.• Ability to manage multiple providers and payors simultaneously.• Familiarity with US healthcare compliance and regulatory requirements.

Regards,

Human Resources

Amvik Solutions Pvt. Ltd.,