Credentialing Analyst

Location: Mohali

Job Title:

Credentialing Analyst
Experience

Required:

1+ Year

Location:

Mohali, Punjab

Shift:  Night Shift

Employment Type:

Full-time
Work Mode:  On-site

Job Summary
Nath Outsourcing Solutions Pvt. Ltd. is seeking an experienced  Credentialing Analyst  with a minimum of 1 year of hands-on experience in provider credentialing and enrollment. The role focuses on maintaining accurate provider records, managing CAQH profiles, and ensuring timely and compliant enrollment with insurance payers.

Key Responsibilities
Perform provider credentialing by registering providers with insurance payers to enable accurate billing.
Manage provider enrollment and contracting processes to ensure providers are set up as in-network.
Create, update, and maintain provider profiles on CAQH and other credentialing platforms.
Collect, verify, and manage credentialing documentation including W-9, CLIA, IRS Letter, Medical License, COI, etc.
Work on credentialing and enrollment tools such as CMD, Modio, or similar platforms.
Utilize payer portals including PECOS and Availity for enrollment, updates, and maintenance.
Apply knowledge of NUCC taxonomy codes and NPDB during provider setup.
Conduct Primary Source Verification (PSV) in compliance with regulatory and organizational standards.

Required

Skills & Qualifications
Minimum 1 year of experience in provider credentialing and/or enrollment.
Strong working knowledge of CAQH, PECOS, and Availity portals.
Clear understanding of credentialing vs. provider enrollment processes.
Familiarity with NUCC taxonomy codes and healthcare data standards.
Experience using credentialing software such as CMD, Modio, or similar tools.
High attention to detail with strong organizational and documentation skills.
Excellent verbal and written communication skills.
Ability to manage confidential provider information with accuracy and discretion.

Preferred Qualifications
Experience working with multiple insurance payers and healthcare networks.
Prior exposure to a healthcare BPO or RCM environment.
Basic understanding of U.S. healthcare billing and compliance standards.

Company:  Nath Outsourcing Solutions Pvt. Ltd.

Location:

Mohali, Punjab