Full Time Remote

Credentialing Manager

India
About the Company

We are hiring experienced Credentialing Managers who can handle the entire process managing a team of Credentialing Specialists, along with enrolling healthcare providers with insurance companies. This is a permanent work-from-home role and requires strong attention to detail, good communication, and the ability to manage multiple applications independently.

About the Role

Manage end-to-end provider credentialing and insurance enrollment for individual and group providers.

Responsibilities
  • Submit and track enrollment applications across all US states.
  • Team Leadership: Guiding a team of credentialing specialists, tracking turnaround times (TAT), and solving complex insurance denial escalations.
  • System Knowledge: Expert-level familiarity with PECOS, CAQH, and specific Revenue Cycle Management (RCM) tools.
  • Attention to Detail: Tracking expiration dates for numerous documents simultaneously without error.
  • File Letters of Interest (LOIs) and follow up with insurance payers via calls and emails.
  • Work with private insurance, Medicare, Medicaid, Medicaid MCOs, and Medicare Advantage plans.
  • Maintain and update provider profiles on portals like:
    • CAQH
    • PECOS
    • Availity
    • Navinet
    • NPPES
  • Apply for and renew provider licenses such as:
    • Professional licenses
    • DEA
    • Controlled Substance licenses
    • Ensure provider information and documents are always accurate and up to date.
    • Regularly update clients on application status and ensure providers remain active with payers.
    • Work independently while staying highly engaged with the remote team.
Qualifications
  • Minimum 6-8 years of hands-on experience in provider credentialing and enrollment.
  • At least 2 years of experience as a Credentialing Manager / Team Lead
Required Skills
  • Strong understanding of documents required for individual and group enrollments.
  • Proven experience handling payer communication and follow-ups.
  • Comfortable managing multiple applications with accuracy and deadlines.
  • Excellent organization and time-management skills.
  • Strong written and verbal communication skills for remote work.
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