Role Description
We are a U.S.-based medical practice seeking a detail-obsessed Provider Credentialing & Enrollment Specialist to own our end-to-end credentialing and credential-maintenance function across multiple physicians, locations, payers, and entities. This is not a forms-submission role: success is measured by whether every provider is correctly enrolled, active, and billable with every required payer, and whether no license, registration, or credentialing item ever expires unnoticed.
You will work remotely from Pune or New Delhi / NCR, on a schedule that overlaps U.S. business hours, communicating directly with our physicians, billing team, payers, and licensing boards. We are looking for someone who follows up relentlessly, catches small data mismatches before they cause denials, and treats credentialing as a revenue-cycle function rather than paperwork.
Qualifications
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5+ years of U.S. healthcare provider credentialing or payer enrollment experience.
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Hands-on experience maintaining physician licenses, DEA registrations, CAQH profiles, malpractice documents, CME records, and payer recredentialing deadlines.
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Working knowledge of Medicare, Medicaid, and commercial insurance enrollment workflows, including the difference between credentialing, contracting, and being loaded/billable.
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Proficiency with CAQH ProView, NPPES, PECOS, payer portals, and state licensing board websites; comfortable learning new portals without hand-holding.
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Strong attention to detail with the ability to identify inconsistencies in provider demographics, TINs, NPIs, addresses, licenses, and payer records.
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Ability to build and maintain credentialing trackers, expiration dashboards, and payer follow-up logs (Excel, Airtable, Smartsheet, Notion, BambooHR, or credentialing software).
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Excellent written English and persistent, professional follow-up skills.
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Ability to manage multiple providers, locations, payers, and deadlines simultaneously and work independently.
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Fluent spoken and written English, a reliable high-speed internet connection, and a quiet home-office setup.
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Willing and able to work hours that overlap with U.S. business hours.
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Based in Pune or New Delhi / NCR.
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High level of confidentiality and professionalism when handling sensitive provider information.
Requirements
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Manage initial provider enrollment, recredentialing, and revalidation across Medicare (PECOS), Medicaid, and commercial payers.
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Complete and maintain payer applications, link providers to the correct group / TIN, manage practice locations, effective dates, and provider terminations.
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Maintain accurate CAQH ProView profiles, attestations, and NPPES / NPI records for all providers.
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Track and prevent expiration of state medical licenses, DEA registrations, DPS/CDS registrations, board certifications, malpractice coverage, CME, ACLS/BLS, and other expirable documents.
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Maintain a live credentialing database and tracker capturing status, missing items, follow-up dates, effective dates, revalidation dates, and approval proof for every provider, payer, and location.
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Follow up with payers every 7β14 days, escalate stalled applications, and confirm that each provider is approved, loaded correctly, and billable under the right entity, TIN, and location.
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Verify the accuracy of provider demographics β legal name, NPI, TIN, addresses, license numbers, taxonomy, PTAN, and effective dates β to prevent enrollment delays and claim denials.
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Collect, name consistently, and securely store credentialing documents (CVs, licenses, DEA/DPS, board certs, diplomas, malpractice face sheets, W-9s, IDs, etc.).
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Communicate clearly and professionally in English with physicians, billing, HR, administrators, payer representatives, licensing boards, and malpractice carriers.
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Keep the billing team informed of exactly when each provider becomes active and billable with each payer, and flag credentialing risks that affect new-location launches, start dates, and cash flow.
Benefits
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Compensation: βΉ8β10 LPA (based on experience)
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Full-time, Permanent employment
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Remote work from home
Company Description
Remote position; candidates must be based in Pune or New Delhi / NCR.
Must work hours that overlap with U.S. business hours (U.S. time-zone support).