Credentialing Specialist - Healthcare / Medical

NationsBenefits India; Plantation (FL); On-site; USD 42,000 - 65,000; Full time

Job summary

NationsBenefits India is seeking a detail-oriented Credentialing Specialist to support credentialing and re-credentialing of providers in our hearing and vision networks.

You will manage applications, maintain records, coordinate with verification bodies, and assist the Credentialing Committee to ensure timely, accurate credentialing status. This role requires sharp organizational skills and strong communication in a fast-paced healthcare operations environment.

Qualifications

• Experience with credentialing programs and documentation.
• Familiarity with NCQA standards is a plus.
• Ability to work with provider networks and managed care teams.

Responsibilities

• Process provider credentialing and re-credentialing applications
• Maintain provider records and credentialing files
• Track credentialing documents and ensure timely processing
• Communicate with providers to obtain required documentation
• Review applications for completeness and accuracy
• Monitor credentialing status and maintain records
• Draft and update credentialing approval letters
• Coordinate with verification organizations and internal teams
• Support Credentialing Committee meetings and maintain records
• Generate reports related to credentialing activities
• Maintain electronic and hard-copy credentialing files

Skills

Healthcare credentialing experience

Provider relations

Organizational skills

Attention to detail

Communication skills

Multitasking

Independent and collaborative work

Tools

Microsoft Excel

Microsoft Office

Job description

We are seeking a detail-oriented Credentialing Specialist to support the credentialing and re-credentialing of providers participating in our hearing and vision provider networks.

Key Responsibilities

• Process provider credentialing and re-credentialing applications
• Maintain provider records and credentialing files
• Track provider credentialing documents and ensure timely processing
• Communicate with providers to obtain required documentation and updates
• Review provider applications for completeness and accuracy
• Monitor provider credentialing status and maintain accurate records
• Draft, track, and update provider credentialing approval letters
• Coordinate with credentialing verification organizations and internal teams
• Support Credentialing Committee meetings and maintain meeting records
• Generate reports related to credentialing activities and provider status
• Maintain electronic and hard-copy credentialing files in accordance with company standards

Qualifications

• Healthcare credentialing experience preferred
• Experience with provider relations, managed care, or healthcare operations
• Strong organizational and follow-up skills
• Excellent attention to detail and accuracy
• Strong communication and customer service skills
• Proficiency in Microsoft Excel and Microsoft Office applications
• Ability to manage multiple priorities in a fast-paced environment
• Ability to work independently and collaboratively

Preferred Qualifications

• Experience with provider credentialing and re-credentialing
• Knowledge of NCQA credentialing standards
• Experience working with healthcare providers and provider networks
• Managed care organization experience
• Experience in healthcare administration or provider support

If you're looking to grow your career in healthcare operations and provider credentialing, we'd love to hear from you.