Assistant Manager - Credentialing

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

Shifts : Night Shift (7:30 pm – 4:45 am) Monday to Friday

Salary : Commensurate with experience

Employment Type : Permanent Job, Full Time

Industry : Healthcare IT, IT Software, Software Services

Role Category : Healthcare Data, Electronic Health Record (EHR) Implementation

Work Location : A303 Bestech Business Tower, Sector-66, Mohali, Punjab

Bikram Gill – HR Director

Email :

Phone :