Manager/Sr. Manager/AGM Credentialing (Midshift)

Company Overview

e-care India is a prominent medical billing organization established in 2000, pioneering offshore medical billing services from India. With over 1000 employees across three delivery centers, e-care provides comprehensive medical billing and coding solutions, adhering to the highest standards of information security with ISO 9001:2015 and ISO 27001:2013 certifications, ensuring compliance with HIPAA regulations.

Position Summary

We are seeking an experienced Credentialing Manager with 10 to 18 years of relevant experience based in Chennai. This role requires working from the office during midshift hours.

Key Responsibilities

• Act as the primary liaison with external payors, maintaining accurate provider information and current credentialing statuses.
• Track license and certification expiry dates, proactively managing renewals to prevent service interruptions.
• Develop, update, and enforce internal credentialing policies, procedures, and compliance standards.
• Prepare and maintain precise, timely reports detailing the credentialing status for all providers.
• Oversee appropriate enrollment into Medicare, Medicaid, CAQH, PECOS, and various commercial payor portals.
• Assist with audit preparations, ensuring proper documentation for regulatory and accreditation requirements.
• Continuously enhance credentialing workflows and address complex compliance matters.
• Support the negotiation and documentation processes related to new insurance contracts and provider affiliations.

Candidate Profile

• Strong verbal and written communication skills.
• Willingness to work onsite in Chennai during midshift hours.
• Extensive experience (minimum 10 years) in credentialing, including expertise in both commercial and federal applications.
• Proven experience in client coordination and communication.
• Preference for candidates residing in Chennai.