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Provider Enrollment and Credentialing Leader

Provider Enrollment and Credentialing Leader

Knack RCMRepublic Of India, IN
23 hours ago
Job description

About the Role :

The Manager – Provider Enrollment & Credentialing will be responsible for overseeing the end-to-end provider enrollment, credentialing, and re-credentialing processes for healthcare providers across multiple payers.

This role involves managing a team, ensuring compliance with payer and regulatory requirements, maintaining strong client relationships, and driving process efficiency and quality across all credentialing operations.

Location : Mohali (On-site)

Key Responsibilities :

Team & Operations Management

  • Lead and mentor the Credentialing and Provider Enrollment team, ensuring productivity, accuracy, and adherence to SLAs.
  • Oversee day-to-day operations related to CAQH management, payer applications, NPI, and Medicare / Medicaid enrollments.
  • Manage re-credentialing, demographic updates, and enrollment follow-ups with payers.
  • Ensure completion of applications, verifications, and documentation within defined timelines.

Process Improvement & Compliance

  • Establish and maintain process documentation, SOPs, and performance trackers.
  • Monitor quality and turnaround time (TAT) and implement corrective actions when required.
  • Ensure all credentialing processes comply with NCQA, CMS, and payer-specific regulations.
  • Identify process gaps and recommend automation or standardization opportunities.
  • Client & Stakeholder Communication

  • Serve as a primary point of contact for clients, addressing escalations and ensuring satisfaction.
  • Collaborate with cross-functional departments (Operations, IT, HR, Quality) to support smooth functioning of credentialing workflows.
  • Conduct regular business review meetings (internal & client-facing) to present performance and improvement metrics.
  • Reporting & Metrics

  • Track and report KPIs including application submission, approval rates, and error percentages.
  • Generate weekly / monthly performance reports and share insights for leadership review.
  • Qualifications :

  • Bachelor’s degree in Healthcare, Business Administration, or related field (Master’s preferred).
  • Minimum 8 years of RCM experience with at least 3 years in credentialing management.
  • Prior experience in client handling and process transition will be an added advantage.
  • Why Join Knack RCM :

  • Work with one of the most trusted and established names in the RCM industry.
  • Opportunity to lead a growing credentialing vertical with strong client exposure.
  • Transparent, performance-driven environment with structured growth path.
  • Employee-friendly culture that values skill, ownership, and innovation.
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    Enrollment • Republic Of India, IN

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