Open to opportunities

Shiva Poojan

@shivapoojan

Provider Enrollment & Credentialing Specialist driving compliant network onboarding and payer-ready credentialing workflows.

India

Message

What I'm looking for

I’m looking to own provider enrollment and credentialing workflows end to end—ensuring regulatory compliance, clean CAQH/licensing documentation, and fast payer validations—while continuously optimizing processes to reduce application processing lag.

I’m a Provider Enrollment & Credentialing Specialist with over 4 years of healthcare administration experience, focused on end-to-end provider credentialing and accelerating insurance network enrollment timelines. I take pride in rigorous regulatory compliance and maintaining documentation integrity across payer relations.

In my recent roles as a Senior Application Specialist, I’ve owned provider enrollment and onboarding workflows as a central point of contact for network tracking. I audit and verify critical compliance data (state licenses, DEA certificates, malpractice history, education, and board certifications) using tools like Medallion Software, Modio Software, and CAQH ProView, while proactively following up with payers to resolve pending files and reduce processing lag.

Experience

Work history, roles, and key accomplishments

Current

Senior Application Specialist

Current

Employee Tech Center India Private Limited

Jul 2025 - Present (1 year)

Own and manage end-to-end provider enrollment and onboarding workflows, serving as the central point of contact for network tracking. Audit and verify provider compliance data and manage payer communications to resolve application status issues.

Provider Enrollment Credentialing Compliance Auditing State Licensing Malpractice Enrollment Primary Source Verification Insurance Payer Relations Workflow Optimization Issue Resolution Medallion Software Data Integrity Tracking Sheets

Senior Application Specialist

GeBBS Healthcare Solutions

Jul 2022 - Jul 2025 (3 years)

Coordinated high-volume credentialing packets for healthcare practitioners across multiple insurance panels. Managed quarterly CAQH re-attestations, used Modio to track application progress, and escalated pending files via telephone and portal follow-ups.

Provider Enrollment CAQH Re Attestation Issue Resolution Insurance Payer Relations Portal Follow Ups

Customer Service Associate

Tech Mahindra & Q Conneqt Business Solutions

Aug 2018 - Mar 2022 (3 years 7 months)

Provided high-quality resolution for complex corporate and customer queries, supporting communication needs for navigating payer-related workflows. Followed data documentation standards and corporate confidentiality requirements across multi-year project assignments.

Customer Service Issue Resolution Data Documentation Confidentiality Communication