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Position: Credentialing & Compliance Specialist
Location: Ahmedabad (On-site)
Shift: US Shift (Night Shift)
Experience: 1–3 Years
Working Days: 5–5.5 Days
Job Summary:
We are seeking a detail-oriented and experienced Credentialing & Compliance Specialist to manage end-to-end provider credentialing and ensure adherence to US healthcare regulatory standards.
Key Responsibilities:
– Manage credentialing and re-credentialing of healthcare providers
– Verify provider credentials including education, licenses, certifications
– Handle payer enrollment (Medicare, Medicaid, Commercial)
– Maintain provider records and databases
– Track license expirations and renewals
– Ensure compliance with NCQA, HIPAA standards
– Conduct background checks (OIG, SAM)
– Support audits and compliance reviews
Key Requirements:
– 1–3 years experience in US Healthcare Credentialing
– Knowledge of CAQH, NPPES, PECOS
– Strong attention to detail and communication skills
Preferred Skills:
– Experience with credentialing tools
– Knowledge of US healthcare insurance
Benefits:
– Competitive salary
– Career growth opportunities