Job Description

Company

: Human Xpert India Pvt. Ltd.

Location :39,Chettinad Chambers(4th Floor Dr.Radha Krishnan Salai, 5th St, Mylapore, Chennai, Tamil Nadu 600004

India (Onsite / Hybrid / Remote - as applicable)

Employment Type

Full-time

Job Summary

Human Xpert India Pvt. Ltd. is seeking an experienced

SME - Credentialing

to manage and oversee end-to-end provider credentialing and re-credentialing processes. The ideal candidate will have strong domain expertise, ensure compliance with regulatory and payer requirements, and support process improvement and team guidance.

Key Responsibilities

Handle end-to-end

provider credentialing and re-credentialing

for physicians and allied healthcare providers Ensure compliance with

NCQA, CMS, state, and payer-specific guidelines

Review and verify provider documents including licenses, certifications, DEA, NPI, and malpractice insurance Coordinate with insurance payers, hospitals, and internal teams for timely credentialing approvals Maintain accurate and up-to-date credentialing records and databases Act as a

subject matter expert

for credentialing-related queries and escalations EFT , ERA and portal creation , provider data base management Conduct audits and quality checks to ensure adherence to SLAs and compliance standards Support training and mentoring of junior credentialing staff Identify process gaps and recommend improvements to enhance efficiency and accuracy Prepare reports and dashboards related to credentialing status and performance metrics
Required Skills & Qualifications

Bachelor's degree in Life Sciences, Healthcare Administration, or a related field

1 -6+ years of experience

in US healthcare credentialing Strong knowledge of

provider enrollment and credentialing workflows

Familiarity with

NCQA, CAQH, CMS, and payer portals

Excellent analytical, documentation, and communication skills Ability to handle complex cases and escalations independently Strong attention to detail and time-management skills
Preferred Qualifications

Prior experience as an

SME or Team Lead

in credentialing Experience working with US healthcare clients Exposure to audits and compliance reviews Certification in healthcare credentialing (if applicable)
Key Competencies

Subject matter expertise in credentialing Problem-solving and decision-making Quality and compliance orientation Team mentoring and collaboration
Pay: From ?30,000.00 per month

Benefits:

Food provided Paid sick time Provident Fund
Work Location: In person

Expected Start Date: 07/01/2026