Assistant Manager – Credentialing
Job Description
1. Reports to the Director of Credentialing & Contracting:
- Provide regular updates on the team's performance, including key metrics, achievements, and
any areas needing improvement
- If the team is working on specific projects, the manager will keep the director informed of
progress, milestones, and any potential roadblocks
- Regularly report on the team's progress towards set goals and objectives, ensuring they align
with the overall organizational strategy
- Swift reporting of challenges or issues that the team is facing, such as resource constraints,
conflicts, or technical problems
- Make recommendations to the director on how to improve performance, optimize processes,
or address issues
- Report on team morale, individual performance within the team, and any training or
development needs
2. Manage Payer Enrollment Process:
- Ability to complete, coordinate and audit provider applications and credentialing packets for
provider
- Ensure all necessary documentation (licenses, certifications, malpractice insurance, etc.) is
up to date and submitted
3. Maintain Compliance:
- Stay updated on payer requirements and government regulations (e.g., CMS, state Medicaid
programs)
- Ensure timely recredentialing and re-enrollment to avoid gaps in coverage or billing
disruptions
4. Team Oversight:
- Assists in creating a supportive and flexible environment that encourages communication and
feedback, as well as modeling and promoting healthy work habits
- Supervise a team of Team Leads, Credentialing Specialists, Coordinators and Trainees
- Develop and implement policies, procedures, and timelines to streamline the enrollment
process
- Ensures the processes and measures are in place to monitor and guide employee
performance and activities
- Work Closely with those tasked as trainers to make sure that measures, and requirements are
successfully met
5. Payer Relations:
- Serve as the liaison between providers and insurance companies
- Follow up on escalated applications and troubleshoot any issues or delays
6. Database and System Management:
- Maintain accurate records in credentialing or enrollment databases (e.g., CAQH, PECOS,
Availity)
- Generate reports and track status of applications and expirations
7. Cross-Department Coordination:
- Work closely with internal company department heads to ensure providers are enrolled and
credentialed before they begin billing claims (billing/onboarding)
Job Requirements
- Strong knowledge of US healthcare and insurance company requirements.
- Understanding of multiple provider specialties and facilities
- Familiarity with credentialing software and systems
- Organizational and multitasking abilities
- Strong leadership skills
- Excellent written and oral English communication skills
- Positive team player attitude
- Strong analytic and reporting skills
- Highly proficient with computers, especially Word and Excel
- Ability to work in night shifts
Preferred Qualifications
Qualification: Bachelor’s or higher degree in Science, Commerce, Accounting or related field
Experience: Minimum of 10 years’ experience in US healthcare industry
Shifts: Night Shift (6:30 pm – 4:00 am) Monday to Friday
Salary: Commensurate with experience
Work Location: Mohali
Pay: ₹50,000.00 - ₹100,000.00 per month
Education:
Work Location: In person
