Credentialing Specialist

We are seeking a detail-oriented and proactive Credentialing Analyst to manage the end-to-end credentialing process for healthcare providers. This role involves timely onboarding, payor credentialing, documentation, and compliance tracking to ensure all providers meet regulatory and client requirements.

Key Responsibilities:

• Manage onboarding of new providers, including welcome communication, documentation, and source verification.

• Handle Collaborative Agreements and update provider records in systems like Athena and CredentialMyDoc (CMD).

• Submit and track payor applications and rosters; ensure follow-ups with payors.

• Allocate and prioritize tasks via CMD based on daily workload.

• Maintain and update CAQH profiles every 120 days for active providers.

• Conduct monthly OIG verifications and ensure compliance with client requirements.

• Prepare regular reports on credentialing holds, provider onboarding status, and facility credentialing by payor.

• Respond promptly to credentialing-related emails and follow-ups within 24 hours.

• Participate in weekly calls with internal stakeholders and clients.

• Maintain and update SOPs related to credentialing.

Requirements:

• Prior experience in healthcare credentialing or provider onboarding preferred.

• Work From Office (Ahmedabad Only)

• Excellent communication skills in English, both written and verbal.

• Strong attention to detail, organization, and time management.

• Familiarity with systems like Athena, CMD, and CAQH is an advantage.

Qualification:

• Graduation in any stream.

• Prior experience in healthcare credentialing or provider onboarding is preferred.