Walk-in | Credentialing Specialist

Info Hub; Eachanari; On-site; INR 350,000 - 550,000; Full time

Job summary

Info Hub is seeking an experienced Credentialing Specialist to manage end-to-end provider credentialing and re-credentialing processes in Tamil Nadu. You will prepare, review, and submit applications to Medicare, Medicaid, and commercial payers, while maintaining accurate credentialing files.

Key duties include verifying qualifications, tracking expirations, ensuring NCQA/CMS/compliance standards, and communicating with payers and internal teams to resolve delays.

Qualifications

• 23 years of experience in healthcare credentialing or provider enrollment.
• Strong knowledge of credentialing processes, payer requirements, and compliance standards.
• Familiarity with Medicare, Medicaid, and commercial payer portals.
• Experience with credentialing software and provider databases.
• Excellent organizational and documentation skills.
• Strong written and verbal communication skills.
• Ability to manage multiple providers and deadlines effectively.
• High attention to detail and accuracy.

Responsibilities

• Perform end-to-end provider credentialing and re-credentialing activities.
• Prepare, review, and submit credentialing applications to commercial, Medicare, and Medicaid payers.
• Verify provider qualifications including licenses, certifications, education, training, work history, and malpractice history.
• Maintain accurate and up-to-date provider credentialing files and databases.
• Track credentialing status, expirations, and renewals to ensure timely re-credentialing.
• Follow up with payers, providers, and internal teams to resolve delays or discrepancies.
• Ensure compliance with NCQA, CMS, state regulations, and payer-specific requirements.
• Conduct regular audits of credentialing files to ensure accuracy and completeness.
• Prepare and share credentialing status reports with management or clients.
• Support provider enrollment, terminations, and demographic updates as required.

Skills

Credentialing experience

Payer requirements

Medicare/Medicaid familiarity

Documentation skills

Communication skills

Deadline management

Attention to detail

Provider enrollment

Tools

Credentialing software

Provider databases

Job description

Key Responsibilities

• Perform end-to-end provider credentialing and re-credentialing activities.
• Prepare, review, and submit credentialing applications to commercial, Medicare, and Medicaid payers.
• Verify provider qualifications including licenses, certifications, education, training, work history, and malpractice history.
• Maintain accurate and up-to-date provider credentialing files and databases.
• Track credentialing status, expirations, and renewals to ensure timely re-credentialing.
• Follow up with payers, providers, and internal teams to resolve delays or discrepancies.
• Ensure compliance with NCQA, CMS, state regulations, and payer-specific requirements.
• Conduct regular audits of credentialing files to ensure accuracy and completeness.
• Prepare and share credentialing status reports with management or clients.
• Support provider enrollment, terminations, and demographic updates as required.

Required Qualifications

• 23 years of experience in healthcare credentialing or provider enrollment.
• Strong knowledge of credentialing processes, payer requirements, and compliance standards.
• Familiarity with Medicare, Medicaid, and commercial payer portals.
• Experience with credentialing software and provider databases.
• Excellent organizational and documentation skills.
• Strong written and verbal communication skills.
• Ability to manage multiple providers and deadlines effectively.
• High attention to detail and accuracy.

Preferred Skills

• Knowledge of NCQA and CMS guidelines.
• Experience handling audits and re-credentialing cycles.
• Proficiency in Microsoft Office (Excel, Word).
• Ability to work independently and collaboratively in a team environment.
• Problem-solving mindset with proactive follow-up skills.

Key Competencies

• Compliance & Quality Focus
• Time Management
• Provider & Payer Coordination
• Analytical & Documentation Skills
• Client Communication.