Specialist I - Data & Content Management

About Us  Zelis is modernizing the healthcare financial experience in the United States (U.S.) by providing a connected platform that bridges the gaps and aligns interests across payers, providers, and healthcare consumers. This platform serves more than 750 payers, including the top 5 health plans, BCBS insurers, regional health plans, TPAs and self-insured employers, and millions of healthcare providers and consumers in the U.S. Zelis sees across the system to identify, optimize, and solve problems holistically with technology built by healthcare experts—driving real, measurable results for clients.   Why We Do What We Do  In the U.S., consumers, payers, and providers face significant challenges throughout the healthcare financial journey. Zelis helps streamline the process by offering solutions that improve transparency, efficiency, and communication among all parties involved. By addressing the obstacles that patients face in accessing care, navigating the intricacies of insurance claims, and the logistical challenges healthcare providers encounter with processing payments, Zelis aims to create a more seamless and effective healthcare financial system. Zelis India plays a crucial role in this mission by supporting various initiatives that enhance the healthcare financial experience. The local team contributes to the development and implementation of innovative solutions, ensuring that technology and processes are optimized for efficiency and effectiveness. Beyond operational expertise, Zelis India cultivates a collaborative work culture, leadership development, and global exposure, creating a dynamic environment for professional growth. With hybrid work flexibility, comprehensive healthcare benefits, financial wellness programs, and cultural celebrations, we foster a holistic workplace experience. Additionally, the team plays a vital role in maintaining high standards of service delivery and contributes to Zelis’ award-winning culture.  Position Overview A credentialing specialist is responsible for verifying and assessing the credentials of healthcare providers

• Processing initial credentialing and re-credentialing applications.
• Screening practitioners' applications and supporting documentation to ascertain their eligibility.
• Collecting information and adding the provider details to the National Practitioner Data Bank (NPDB) portal, the applicant and their malpractice insurer, and other relevant sources.
• Identifying discrepancies in information and conducting follow-ups.
• Adhering to the deadline from Credentialing Committee.
• Assisting customers with credentialing inquiries if required.
• Capturing primary source documentation in computer databases.
• Ensuring data is backed up.
• Ensuring compliance with applicable laws, regulations, procedures, and policies are followed.
• Masters in any stream, or suitable equivalent.
• 2+ years of credentialing experience or has worked in US Healthcare process.
• Knowledge of medical credentialing and privileging procedures and standards.
• Excellent verbal and written communication skills.
• Proficient with Microsoft Office Word and Excel.
• Proficient typing skills.
• Time management skills