Credentialing Specialist

Dear All,

Greetings from Flatworld Healthcare Services.

WE ARE HIRING !!

Job Title: Credentialing & Provider Enrollment Specialist

Department: Revenue Cycle Management (RCM)

Experience Required: 1 to 5 Years

Location: Bangalore

Employment Type: Full-time

Interested candidates can share their CVs at pavan.v@finnastra.com or contact 9035473861 (Available between 1 PM - 10 PM).

Job Summary:

We are seeking a detail-oriented and proactive Credentialing & Provider Enrollment Specialist with 12 years of experience in the healthcare RCM domain. The ideal candidate will be responsible for managing end-to-end provider credentialing, re-credentialing, and enrollment with insurance payers, ensuring compliance with regulatory standards and timelines.

Key Responsibilities:

• Complete initial and re-credentialing applications for healthcare providers.
• Submit and track enrollment applications with Medicare, Medicaid, and commercial payers.
• Maintain and update provider information in internal databases and payer portals.
• Monitor expirables (licenses, certifications, etc.) and ensure timely renewals.
• Communicate with providers, payers, and internal teams to resolve enrollment issues.
• Ensure compliance with payer-specific and regulatory credentialing requirements.
• Follow up with insurance companies to check application status and resolve delays.
• Assist in audits and provide necessary documentation as required.

Qualifications:

• 1 to 4 years of hands-on experience in provider credentialing and enrollment.
• Knowledge of payer requirements and CAQH, PECOS, NPPES, etc.
• Strong communication, organizational, and follow-up skills.
• Proficient in MS Office and credentialing software/tools.

Preferred Skills:

• Experience working with U.S. healthcare providers.
• Familiarity with medical billing and insurance guidelines.
• Ability to manage multiple priorities in a deadline-driven environment.

Perks & Benefits:

• 5 Days Working
• Provident Fund & Gratuity
• Medical Insurance
• Travel Allowance

Fresher and non-relevant experience applicants, please ignore!