Credentialing Analyst

Job Title: Credentialing Analyst

Experience Required: 1+ Year

Location: Mohali, Punjab

Shift: Night Shift

Employment Type: Full-time

Work Mode: On-site

Job Summary

Nath Outsourcing Solutions Pvt. Ltd. is seeking an experienced Credentialing Analyst with a minimum of 1 year of hands-on experience in provider credentialing and enrollment. The role focuses on maintaining accurate provider records, managing CAQH profiles, and ensuring timely and compliant enrollment with insurance payers.

Key Responsibilities

• Perform provider credentialing by registering providers with insurance payers to enable accurate billing.
• Manage provider enrollment and contracting processes to ensure providers are set up as in-network.
• Create, update, and maintain provider profiles on CAQH and other credentialing platforms.
• Collect, verify, and manage credentialing documentation including W-9, CLIA, IRS Letter, Medical License, COI, etc.
• Work on credentialing and enrollment tools such as CMD, Modio, or similar platforms.
• Utilize payer portals including PECOS and Availity for enrollment, updates, and maintenance.
• Apply knowledge of NUCC taxonomy codes and NPDB during provider setup.
• Conduct Primary Source Verification (PSV) in compliance with regulatory and organizational standards.

Required Skills & Qualifications

• Minimum 1 year of experience in provider credentialing and/or enrollment.
• Strong working knowledge of CAQH, PECOS, and Availity portals.
• Clear understanding of credentialing vs. provider enrollment processes.
• Familiarity with NUCC taxonomy codes and healthcare data standards.
• Experience using credentialing software such as CMD, Modio, or similar tools.
• High attention to detail with strong organizational and documentation skills.
• Excellent verbal and written communication skills.
• Ability to manage confidential provider information with accuracy and discretion.

Preferred Qualifications

• Experience working with multiple insurance payers and healthcare networks.
• Prior exposure to a healthcare BPO or RCM environment.
• Basic understanding of U.S. healthcare billing and compliance standards.

Company: Nath Outsourcing Solutions Pvt. Ltd.

Location: Mohali, Punjab