Circle Health
Website:
circlehealth.in
Job details:
Credentialing Specialist (US Healthcare)
Company- Circle Health
Location- Remote (India)
Company Description
Circle Health provides an AI-driven care management and engagement platform designed to address global healthcare challenges like rising costs, aging populations and chronic disease burdens. By focusing on prevention, continuous engagement and personalized care, Circle Health delivers solutions that support physician groups, employers and insurers in improving patient outcomes and reducing healthcare costs. Their approach combines innovative AI technology with human care managers, ensuring seamless, patient-centered care. Trusted by over 100 organizations and serving more than 100,000 lives worldwide, Circle Health is committed to integrating technology for measurable health and cost outcomes.
Role Overview
We are seeking an experienced Credentialing Specialist to manage provider enrollment
and credentialing processes for US healthcare providers. The role will support payer
credentialing, provider enrollment, CAQH management, and compliance with payer and
regulatory requirements.
Key Responsibilities
Provider Credentialing
● Manage end-to-end provider credentialing and re-credentialing processes.
● Prepare and submit credentialing applications to insurance payers.
● Maintain accurate provider credentialing files.
Provider Enrollment
● Enroll providers with Medicare, Medicaid, and commercial payers.
● Complete and submit payer enrollment forms and documentation.
● Track enrollment status and ensure timely approvals.
Primary Source Verification
Verify and maintain records for:
● State medical licenses
● DEA certificates
● Board certifications
● Education and training
● Work history
● Malpractice insurance
Payer Follow-ups
● Communicate with payer credentialing departments.
● Track application status and resolve enrollment issues.
Compliance
● Ensure credentialing activities comply with payer and regulatory standards.
● Maintain audit-ready documentation.
Reporting
● Maintain credentialing trackers and reports.
● Provide status updates to leadership and operations teams.
Required Skills
● 2–5 years experience in US provider credentialing
● Experience with Medicare / Medicaid provider enrollment
● Familiarity with payer credentialing portals
● Experience with provider enrollment applications
Key Traits
● High attention to detail
● Strong documentation skills
● Experience communicating with US payer credentialing departments
How to Apply
Apply directly via this LinkedIn job post or drop a mail to jasraaj@circlehealth.in with CV and brief introduction.
Click on Apply to know more.