Credentialing Specialist

Job Description: 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.

Created: 2025-08-08