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: 2 to 5 Years
Location: Bangalore
Employment Type: Full-time

Interested candidates can share their CVs at [email protected] or contact 9035473862

Job Summary:

We are seeking a detail-oriented and proactive Credentialing & Provider Enrollment Specialist with 2 to 5 years of experience in the healthcare RCM domain. The ideal candidate will be responsible for managing end-to-end provider credentialing, re-credentialing, enrollment with insurance payers, and contract negotiation activities while 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
  • Handle payer contract negotiations, follow-ups, and agreement coordination

Qualifications:

• 2 to 5 years of hands-on experience in provider credentialing and enrollment
  • Experience in contract negotiation with insurance payers is preferred
  • 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!