Mathe Mrudula

Experienced Credentialing Specialist with 6years in Healthcare industry. Skilled in verifying healthcare provider information, collecting and verifying date and managing credentialing aplications.

Senior Credentialing Specialist at Apollo Healthaxis (Nexify Health) (2025-08 – Present)

• Obtained and verified credentials for all licensed medical providers for initial credentialing.
• Collected or enrolled renewal of license such as medical license, DEA, Education, Work history, NPI, verified internships, residencies, Fellowships, Reviewed malpractice insurance.
• Verified and validated State Professional Licenses, DEA certificates, CDS credentials, board certifications, and educational backgrounds to confirm provider qualifications meet payer and industry standards.
• Managed end-to-end provider credentialing and re-credentialing processes for a US Health Insurance client, monitoring applications and conducting follow-ups with provider offices to ensure timely completion.

Senior Credentialing Specialist at SUTHERLAND HEALTHCARE SOLUTIONS (2019-12 – 2025-07)

• Perform primary source of verification of provider credentials including education, training, licensure, board certification and worm history.
• Track, monitor and process re-credentialing and expiring documents to maintain compliance.
• Work closely with internal teams to solve credentialing issues and escalations.
• Support audits by providing complete and timely documentation.
• Managed end-to-end provider credentialing and re-credentialing processes for a US Health Insurance client, monitoring applications and conducting follow-ups with provider offices to ensure timely completion.
• Verified and validated State professional licenses, DEA certificates, CDS credentials, board certifications, and educational backgrounds to confirm provider qualifications meet payer and industry standards.
• Administered provider Enrollment across multiple panels including Insurance Networks, Managed Care Organizations (MCOs), hospital affiliations, and specialty groups, ensuring compliance with regulatory standard and contractual agreements.
• Maintained and updated accurate provider profiles in CAQH, NPPES, OIG, SAM, Medicare Opt-Out, and CMS databases, ensuring data integrity across all platforms.

BUSSINESS ASSOCIATE at 24/7 KOHL'S PROCESS (2018-09 – 2019-01)

• Determined consumer needs to provide products and services appealing to larger market.
• Evaluated customer feedback and provided recommendation for improve.

B.Tech – Eluru college of engineering and technology (2018)

Intermediate – SRI CHAITANYA JUNIOR COLLEGE (2014)

SSC – AMALODBHAVI HIGH SCHOOL (2014)