Provider Credentialing & Physician Onboarding Specialist U.S. Healthcare

Job Title: Provider Credentialing & Physician Onboarding Specialist – U.S. Healthcare

Employment Type: Full-Time | Permanent | Remote (Work From Home)

Shift Timing: U.S. Night Shift – 7:30 PM to 4:30 AM (IST)

Location: Candidates must be based in Pune only

Joining: Immediate Joiners Preferred

About the Role

We are looking for an experienced Provider Credentialing & Physician Onboarding

Specialist to manage the end-to-end credentialing, payer enrollment, re-credentialing,

and onboarding of physicians and allied healthcare providers. The ideal candidate will

ensure providers are successfully credentialed, enrolled with government and commercial

insurance payers, and onboarded in compliance with regulatory and accreditation

standards. This role requires close coordination with healthcare providers, payer

representatives, and internal stakeholders to ensure timely onboarding, minimize

enrollment delays, and maintain accurate provider records.

Key Responsibilities

Provider Credentialing

• Manage end-to-end provider credentialing, re-credentialing, and credential

maintenance.

• Review credentialing applications for completeness, accuracy, and compliance.

• Conduct Primary Source Verification (PSV)

• Maintain complete and audit-ready credentialing files.

Provider Enrollment

• Prepare, submit, and monitor provider enrollment applications with Medicare

(PECOS), Medicaid, IHCP (Indiana Health Coverage Programs), MHS, and

commercial insurance payers.

• Track application status, resolve deficiencies, and follow up with payer

representatives until enrollment approval.

• Ensure timely completion of provider revalidation and re-enrollment activities.

Physician Onboarding

• Coordinate end-to-end physician and provider onboarding activities.

• Collect onboarding documents and ensure all credentialing and enrollment

requirements are completed before the provider's start date.

• Collaborate with HR, Operations, Practice Managers, and providers to facilitate a

smooth onboarding experience.

System & Database Management

• Maintain accurate provider records in CAQH ProView, Symplr, Cactus, Modio,

VerityStream, MD-Staff, and payer portals.

• Update provider profiles, upload supporting documents, perform CAQH

attestations, and ensure data integrity across all credentialing systems.

Compliance & Documentation

• Ensure compliance with NCQA, CMS, URAC, The Joint Commission (TJC), and

payer-specific credentialing guidelines.

• Monitor provider licenses, DEA registrations, board certifications, malpractice

insurance, and other expiring credentials to ensure uninterrupted provider

participation.

• Prepare reports, maintain credentialing trackers, and support internal and external

audits.

Key Competencies

• Excellent verbal and written English communication skills

• Strong attention to detail and documentation accuracy

• Excellent organizational and time management skills

• Strong analytical and problem-solving abilities

• Ability to prioritize multiple tasks and meet deadlines

• Effective coordination and stakeholder management skills

• Customer-focused approach with strong interpersonal skills

• Ability to work independently in a remote environment

• High level of accountability, ownership, and confidentiality

• Strong follow-up and issue resolution skills

Qualifications

• Bachelor's degree in healthcare administration, Life Sciences, Business

Administration, or a related field (preferred).

• Minimum 3 years of experience in US Healthcare Provider Credentialing,

Provider Enrollment, or Physician Onboarding.

• Hands-on experience with CAQH ProView, Medicare (PECOS), Medicaid, IHCP,

MHS, and commercial payer enrollment processes.

• Strong understanding of Primary Source Verification (PSV) and provider

credentialing workflows.

• Working knowledge of NCQA, CMS, URAC, and The Joint Commission (TJC)

standards.

• Experience using credentialing platforms such as CAQH, Symplr, Cactus, Modio,

VerityStream, MD-Staff, or similar systems.

• Proficiency in Microsoft Office Suite, particularly Excel, Word, and Outlook.

Additional Requirements

• Candidates must currently reside in Pune.

• Immediate joiners are highly preferred.

• Must be willing to work U.S. Night Shift (7:30 PM – 4:30 AM IST).

• Must have a reliable internet connection and a dedicated work-from-home setup.

• Excellent written and verbal English communication is mandatory.

Please Note:

To Apply:

Send your resume at [Confidential Information] or Contact Us on +91 84848 51675

Or directly apply on LinkedIn

Note: Candidates must apply only through LinkedIn or email by sending their updated resume.

Resumes sent via WhatsApp will not be accepted or entertained under any circumstances.