Chennai Tamil Nadu Qualification validation specialist Jobs – 70 Open Jobs Today

Associate II - HealthPlan (Claim Adjudication)
UST —Chennai, Tamil Nadu
- Bachelor's degree
- Communication skills
Quick apply
Operations Specialist
OEConnection —Chennai, Tamil Nadu
- Weekend availability
- Azure
- DevOps
- English
10d
Banking Operations Support Specialist
Citi —Chennai, Tamil Nadu
- Weekend availability
- Microsoft Office
- 12th Pass
- Analysis skills
GxP Specialist
Zifo —Chennai, Tamil Nadu
- Bachelor's degree
- Manufacturing
- Communication skills
Quick apply
Specialist -CFD
Lennox International —Chennai, Tamil Nadu
- Full-time
- Doctoral degree
- CAD
- Engineering
14d
Product Test Specialist
Cognizant —Chennai, Tamil Nadu
- Full-time
- Hybrid work
Specialist (Swachh Bharat Mission) – Capacity Development Programme
Indian Institute for Human Settlements —Chennai, Tamil Nadu
- English
- Master's degree
- Project management
SPE-Policy Servicing
Cognizant —Chennai, Tamil Nadu
- Full-time
- Microsoft Word
- Word processing
- English
11d
Partner Operations Specialist – Global Alliances & Channels
Appian Corporation —Chennai, Tamil Nadu
- CRM software
- Salesforce
- English
- Health insurance
Quick apply
Payroll Specialist - Payroll Time Admin/Labor processor
KBR —Chennai, Tamil Nadu
- Full-time
- Microsoft Excel
- English
- Microsoft Office
- Paid time off
Pharmacovigilance Services Specialist
Accenture —Chennai, Tamil Nadu
- Full-time
- Medicine
- English
- Microsoft Office
4d
Senior Specialist
ZALARIS Deutschland GmbH —Chennai, Tamil Nadu
- Full-time
- Microsoft Excel
- Finance
- Analysis skills
Associate Data Quality Specialist
CSC (Corporation Service Company) —Chennai, Tamil Nadu
- Full-time
- Customer service
- Microsoft Office
- Master's degree
Pricing Specialist
Crane Worldwide Logistics India Pvt Ltd —Chennai, Tamil Nadu
- Microsoft Excel
- Microsoft Office
- Analysis skills
SCIPPA Specialist
Ventra Health, Inc. —Perungudi, Chennai, Tamil Nadu
- Full-time
- Microsoft Excel
5d
AI Solutions Specialist -Implementations
Komodo Health —Chennai, Tamil Nadu
- Hybrid work
- SQL
- AWS
- APIs
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13d
Project Lead
Infinite Computer Solutions Ltd. —Chennai, Tamil Nadu
- B.Sc
- Microsoft Office
- Administrative experience
11d
SAP MDM Consultant - Data migration
Unidos Technology —Thiruvanmiyur, Chennai, Tamil Nadu
- ₹9,00,000 - ₹12,00,000 a year
- Computer Science
- Master's degree
- Analysis skills
Quick apply
16h
Lead Logistics Customer Experience and Operations Specialist
Maersk —Chennai, Tamil Nadu
- Full-time
- Microsoft Excel
- Customer service
- Microsoft Office
3d
Registration/Eligibility Edits Specialist
Ventra Health, Inc. —Perungudi, Chennai, Tamil Nadu
- Full-time
- Microsoft Excel
- Microsoft Outlook
- Basic math
12d

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Associate II - HealthPlan (Claim Adjudication)

UST -
Chennai, Tamil Nadu

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Job details

Qualifications

Education administration
Bachelor's degree
Communication skills

Full job description

Role description

Job Description – Provider Recredentialing Specialist Shift Time : 5:30pm to 2:30am IST Role Summary The Provider Recredentialing Specialist is responsible for managing the end-to-end recredentialing lifecycle for healthcare providers to ensure compliance with payer, regulatory, and accreditation requirements. The role focuses on periodic validation of provider credentials, documentation updates, and ongoing monitoring to maintain an accurate and compliant provider network. Recredentialing is a cyclical process that ensures providers continue to meet required standards through updated verification and monitoring activities. Key Responsibilities 1. Recredentialing Lifecycle Management Manage end-to-end provider recredentialing processes in line with payer and regulatory timelines Initiate recredentialing cases based on due dates, expirable, and renewal triggers Track and manage provider credential expirations (licenses, certifications, malpractice insurance) 2. Documentation & Application Review Collect and review recredentialing applications via systems like CAQH or internal platforms Validate completeness and accuracy of provider documentation Follow up with providers for missing or inconsistent information 3. Primary Source Verification (PSV) Perform PSV for: Licensure Board certification Education & training Work history Validate data from authoritative sources (State Boards, NPPES, OIG, NPDB, etc.) Ensure compliance with regulatory and payer requirements 4. Background & Compliance Checks Conduct sanction and exclusion checks (OIG, NPDB, Medicare/Medicaid) Identify discrepancies, red flags, or compliance risks Escalate issues for further clinical or committee review 5. Provider Data Validation & Quality Checks Ensure accuracy of provider profile (specialty, affiliations, demographics, practice locations) Perform quality audits on completed credentialing files Maintain documentation integrity for audit readiness 6. Workflow Management & Productivity Manage assigned inventory/queue ensuring SLA/TAT adherence Maintain productivity and quality benchmarks (first-time-right processing) Support backlog clearance and aging reduction initiatives 7. Stakeholder Coordination Interact with providers, internal teams, and external verification agencies Support escalations and provide status updates to clients/stakeholders Collaborate with QA, compliance, and operations teams 8. Reporting & Governance Update dashboards and trackers for recredentialing status and closures Highlight risks related to expirable, delays, or compliance gaps Support audit readiness and regulatory reviews Skills & Competencies Strong knowledge of: Provider Credentialing & Recredentialing lifecycle PSV (Primary Source Verification) CAQH, NPPES, NPDB, OIG processes Understanding of US healthcare payer operations High attention to detail and documentation accuracy Analytical & problem-solving mindset Strong communication (provider outreach, escalations) Ability to work with high-volume operations and SLAs Experience & Qualification Experience: 3–6+ years in Provider Credentialing/Recredentialing (BPO/US Healthcare) Education: Bachelor’s degree (Healthcare/Admin/Business preferred) KPIs / Performance Metrics Recredentialing TAT adherence PSV accuracy & compliance score Documentation quality / audit pass rate Queue management (aging, backlog reduction) Value Add (for BPO Portfolio / RFP positioning) Ensures regulatory compliance and reduces audit risk Improves provider network accuracy and reliability Minimizes claim denials due to credentialing gaps Enhances provider onboarding continuity and payer alignment

Skills

Provider Credentialing, NPPES, NPDB, Healthcare Systems

About UST
UST is a global digital transformation solutions provider. For more than 20 years, UST has worked side by side with the world’s best companies to make a real impact through transformation. Powered by technology, inspired by people and led by purpose, UST partners with their clients from design to operation. With deep domain expertise and a future-proof philosophy, UST embeds innovation and agility into their clients’ organizations. With over 30,000 employees in 30 countries, UST builds for boundless impact—touching billions of lives in the process.

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Refine Your Search

qualification validation specialist jobs in chennai tamil nadu

Associate II - HealthPlan (Claim Adjudication)

Operations Specialist

Banking Operations Support Specialist

GxP Specialist

Specialist -CFD

Product Test Specialist

Specialist (Swachh Bharat Mission) – Capacity Development Programme

SPE-Policy Servicing

Partner Operations Specialist – Global Alliances & Channels

Payroll Specialist - Payroll Time Admin/Labor processor

Pharmacovigilance Services Specialist

Senior Specialist

Associate Data Quality Specialist

Pricing Specialist

SCIPPA Specialist

AI Solutions Specialist -Implementations

Project Lead

SAP MDM Consultant - Data migration

Lead Logistics Customer Experience and Operations Specialist

Registration/Eligibility Edits Specialist

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