Job Description

• Prepare, submit, and track provider enrollment applications with commercial and government payers (Medicare/Medicaid, commercial plans).
• Maintain and attest CAQH profiles; manage PECOS, NPPES, and payer portals.
• Follow up with payers on application status and resolve deficiencies quickly and accurately.
• Maintain accurate trackers — effective dates, expirables (licenses, DEA, malpractice), and re-credentialing timelines.
• Handle provider and client data with strict confidentiality and HIPAA compliance.

• Own complete enrollment files end-to-end for assigned clients, including complex group/facility enrollments and payer escalations.
• Run the re-credentialing and expirables calendar so nothing lapses.
• Review associates’ submissions for accuracy and coach on payer-specific requirements.

• Associate: minimum 1 year in US provider credentialing/enrollment. Sr Associate: 3–4 years with end-to-end enrollment ownership.
• Hands-on experience with CAQH, PECOS/NPPES, and payer portals; strong understanding of enrollment workflows and timelines.
• High attention to detail — credentialing errors are expensive and slow to unwind.

• Experience on practice-management / EHR platforms — Epic, AdvancedMD, or athenahealth preferred; similar platforms considered.
• Experience with credentialing software (Modio, MD-Staff, Verity, or similar).

• Education: Bachelor’s degree (any discipline) is mandatory and must be completed — candidates currently pursuing a degree, or with an incomplete/dropped graduation, are not eligible.
• Communication: Moderate-to-strong — good spoken and written English for payer follow-ups and professional, client-facing emails and notes. Accuracy in writing matters as much as speed.
• Work mode & shift: Onsite at Gurugram, 5 days a week, on a fixed night (US-hours) shift — reliable attendance, punctuality, and roster adherence are essential.
• Systems: Comfortable with payer portals, CAQH / PECOS / NPPES, tracker maintenance, and MS Office (Excel/Word).
• Notice period: Immediate joiners or candidates on short notice strongly preferred.

• Applications prepared/submitted and processed per period.
• First-pass approval rate and enrollment turnaround time (TAT).
• Zero lapses on expirables and re-credentialing dates.
• Accuracy / rework rate on submissions.

• HR Screening
• 2 Technical Interviews
• Assessment Round
• HR discussion (fitment, shift, notice).