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Provider Credentialing & Enrollment Specialist

May 28, 2026

Employment Type: Full-time, Permanent Work Location: Remote (work from home) — candidates must be based in Pune or New Delhi / NCR Schedule: Must work hours that overlap with U.S. business hours (U.S. time-zone support) Experience Required: Minimum 5 years in U.S. healthcare provider credentialing / payer enrollment Compensation: ₹8–10 LPA (based on experience) Language: Fluent written and spoken English (required) Reports To: Practice Administrator / Operations Manager Position Overview 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. Key Responsibilities <ul> <li>Manage initial provider enrollment, recredentialing, and revalidation across Medicare (PECOS), Medicaid, and commercial payers.</li> <li>Complete and maintain payer applications, link providers to the correct group / TIN, manage practice locations, effective dates, and provider terminations.</li> <li>Maintain accurate CAQH ProView profiles, attestations, and NPPES / NPI records for all providers.</li> <li>Track and prevent expiration of state medical licenses, DEA registrations, DPS/CDS registrations, board certifications, malpractice coverage, CME, ACLS/BLS, and other expirable documents.</li> <li>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.</li> <li>Follow up with payers every 7–14 days, escalate stalled applications, and confirm that each provider is approved, loaded correctly, and billable under the right entity, TIN, and location.</li> <li>Verify the accuracy of provider demographics — legal name, NPI, TIN, addresses, license numbers, taxonomy, PTAN, and effective dates — to prevent enrollment delays and claim denials.</li> <li>Collect, name consistently, and securely store credentialing documents (CVs, licenses, DEA/DPS, board certs, diplomas, malpractice face sheets, W-9s, IDs, etc.).</li> <li>Communicate clearly and professionally in English with physicians, billing, HR, administrators, payer representatives, licensing boards, and malpractice carriers.</li> <li>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.</li> </ul> Required Qualifications <ul> <li>5+ years of U.S. healthcare provider credentialing or payer enrollment experience.</li> <li>Hands-on experience maintaining physician licenses, DEA registrations, CAQH profiles, malpractice documents, CME records, and payer recredentialing deadlines.</li> <li>Working knowledge of Medicare, Medicaid, and commercial insurance enrollment workflows, including the difference between credentialing, contracting, and being loaded/billable.</li> <li>Proficiency with CAQH ProView, NPPES, PECOS, payer portals, and state licensing board websites; comfortable learning new portals without hand-holding.</li> <li>Strong attention to detail with the ability to identify inconsistencies in provider demographics, TINs, NPIs, addresses, licenses, and payer records.</li> <li>Ability to build and maintain credentialing trackers, expiration dashboards, and payer follow-up logs (Excel, Airtable, Smartsheet, Notion, BambooHR, or credentialing software).</li> <li>Excellent written English and persistent, professional follow-up skills.</li> <li>Ability to manage multiple providers, locations, payers, and deadlines simultaneously and work independently.</li> <li>Fluent spoken and written English, a reliable high-speed internet connection, and a quiet home-office setup.</li> <li>Willing and able to work hours that overlap with U.S. business hours.</li> <li>Based in Pune or New Delhi / NCR.</li> <li>High level of confidentiality and professionalism when handling sensitive provider information.</li> </ul> Preferred Qualifications <ul> <li>Experience credentialing physicians in a multispecialty, nephrology, primary care, hospitalist, or outpatient practice.</li> <li>Experience with Medicare PECOS revalidation and Medicaid enrollment.</li> <li>Experience with commercial payer portals such as Availity, UnitedHealthcare, Optum, Cigna, Aetna, and BCBS.</li> <li>Experience supporting multi-location or multi-entity medical groups.</li> <li>Familiarity with revenue-cycle operations and claim-denial prevention.</li> <li>Certified Provider Credentialing Specialist (CPCS) certification (a plus, not required if experience is strong).</li> </ul> Who Thrives in This Role <ul> <li>Extremely organized, persistent, and detail-obsessed.</li> <li>Comfortable chasing payers and pushing physicians for missing documents — firm but professional.</li> <li>Not easily frustrated by slow payer responses; knows when and how to escalate.</li> <li>Self-directed, reliable with trackers and databases, and revenue-cycle aware.</li> </ul> What Success Looks Like <ol> <li>Every provider is enrolled correctly with every required payer.</li> <li>No license, DEA, DPS, CAQH, CME, malpractice, or payer credentialing item expires unnoticed.</li> <li>Billing always knows exactly when each provider is active, billable, and linked to the correct group, TIN, location, and payer.</li> </ol> How to Apply Submit your resume along with a brief note describing the providers, specialties, payers, and credentialing tools you have worked with. Strong candidates should be able to clearly explain CAQH, PECOS, NPI, TIN, and payer effective dates, and describe their personal system for tracking deadlines and following up with payers.

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Common Interview Questions And Answers

1. HOW DO YOU PLAN YOUR DAY?

This is what this question poses: When do you focus and start working seriously? What are the hours you work optimally? Are you a night owl? A morning bird? Remote teams can be made up of people working on different shifts and around the world, so you won't necessarily be stuck in the 9-5 schedule if it's not for you...

2. HOW DO YOU USE THE DIFFERENT COMMUNICATION TOOLS IN DIFFERENT SITUATIONS?

When you're working on a remote team, there's no way to chat in the hallway between meetings or catch up on the latest project during an office carpool. Therefore, virtual communication will be absolutely essential to get your work done...

3. WHAT IS "WORKING REMOTE" REALLY FOR YOU?

Many people want to work remotely because of the flexibility it allows. You can work anywhere and at any time of the day...

4. WHAT DO YOU NEED IN YOUR PHYSICAL WORKSPACE TO SUCCEED IN YOUR WORK?

With this question, companies are looking to see what equipment they may need to provide you with and to verify how aware you are of what remote working could mean for you physically and logistically...

5. HOW DO YOU PROCESS INFORMATION?

Several years ago, I was working in a team to plan a big event. My supervisor made us all work as a team before the big day. One of our activities has been to find out how each of us processes information...

6. HOW DO YOU MANAGE THE CALENDAR AND THE PROGRAM? WHICH APPLICATIONS / SYSTEM DO YOU USE?

Or you may receive even more specific questions, such as: What's on your calendar? Do you plan blocks of time to do certain types of work? Do you have an open calendar that everyone can see?...

7. HOW DO YOU ORGANIZE FILES, LINKS, AND TABS ON YOUR COMPUTER?

Just like your schedule, how you track files and other information is very important. After all, everything is digital!...

8. HOW TO PRIORITIZE WORK?

The day I watched Marie Forleo's film separating the important from the urgent, my life changed. Not all remote jobs start fast, but most of them are...

9. HOW DO YOU PREPARE FOR A MEETING AND PREPARE A MEETING? WHAT DO YOU SEE HAPPENING DURING THE MEETING?

Just as communication is essential when working remotely, so is organization. Because you won't have those opportunities in the elevator or a casual conversation in the lunchroom, you should take advantage of the little time you have in a video or phone conference...

10. HOW DO YOU USE TECHNOLOGY ON A DAILY BASIS, IN YOUR WORK AND FOR YOUR PLEASURE?

This is a great question because it shows your comfort level with technology, which is very important for a remote worker because you will be working with technology over time...

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