Team Leader - Credentialing

Credentialing Team Lead | Healthcare Operations.

We are looking for an experienced Credentialing Team Lead to join our growing healthcare operations team. This role is ideal for professionals with strong credentialing expertise and team management experience who can ensure compliance, accuracy, and operational excellence.

Key Responsibilities -

Team Management

• Lead, mentor, and supervise a team of credentialing specialists
• Assign tasks, monitor performance, and provide regular feedback
• Conduct training sessions to enhance team knowledge and skills

Credentialing Operations

• Oversee the end-to-end credentialing process, including provider enrollment, verification, and re-credentialing
• Ensure compliance with NCQA, CMS, state, and organizational requirements
• Review and approve credentialing files before submission
• Coordinate with providers and payers to resolve credentialing queries when required

Quality & Compliance

• Maintain high standards of accuracy and turnaround time in credentialing activities
• Implement quality control measures and conduct periodic audits
• Stay updated with regulatory changes and ensure the team follows updated guidelines

Process Improvement

• Identify operational bottlenecks and propose workflow improvements
• Develop and implement best practices in credentialing operations
• Utilize technology and automation tools to improve efficiency

Preferred Candidate Profile

• Experience in US Healthcare Credentialing
• Prior Team Lead / SME / Supervisory experience
• Strong understanding of NCQA, CMS, and payer credentialing processes
• Excellent communication and stakeholder management skills

Location: Hiranandani Gardens, Powai - Mumbai.

Shift: US Shift

Role: Team Lead Credentialing.