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Pe - follow up specialist

https://www.randstad.com Logo

Randstad

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Location:
India , Hyderabad

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Category:
IT - Administration

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Contract Type:
Not provided

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Salary:

Not provided

Job Description:

The primary goal of this position is to manage the complex administrative and compliance-driven processes required for healthcare professionals to practice and for the organization to receive payment. Provider Credentialing (Verification and Compliance) Credentialing is the process of verifying a healthcare provider's qualifications to ensure they meet professional and regulatory standards. It's the quality control step.

Job Responsibility:

  • End-to-End Enrollment Management
  • Compliance & Regulatory Adherence
  • Issue Resolution & Escalations—Investigate and resolve complex enrollment issues—rejections, NPI/taxonomy discrepancies, retro-effective enrollment, and portal conflicts
  • Serve as a point of escalation for difficult payer inquiries
  • Coordinate with internal Quality, Credentialing, and Provider Data teams to address blockers
  • Process Improvement—Identify inefficiencies in the enrollment workflow and recommend enhancements to reduce turnaround time and improve accuracy
  • Support automation and system-improvement initiatives
  • Contribute to building standardized templates and best practices
  • Mentorship & Team Support—Guide and mentor junior Analysts to improve their technical and process knowledge
  • Provide feedback through reviews, quality checks, and coaching discussions
  • Participate in team huddles, calibrations, and performance alignment meetings
  • Documentation & Reporting—Maintain accurate records within CRM, internal workflow tools, payer portals, and tracking sheets
  • Generate periodic reports on submissions, status updates, pending items, and escalations
  • Ensure documentation meets audit and compliance expectations

Requirements:

Minimum 2+ years of hands-on experience in Payer Enrollment—Commercial or Medicaid, depending on the requirement

Additional Information:

Job Posted:
December 26, 2025

Expiration:
January 17, 2026

Employment Type:
Fulltime
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