Shiva Poojan

Detail-oriented and results-driven Provider Enrollment & Credentialing Specialist with over 4 years of dedicated experience in healthcare administration, backed by a strong foundation in customer management lifecycle operations. Expert in managing end-to-end provider credentialing, ensuring rigorous regulatory compliance, and accelerating insurance network enrollment timelines. Highly proficient in utilizing leading industry platforms including Medallion Software, Modio Software, and CAQH to maintain documentation integrity and streamline payer relations.

Senior Application Specialist - Employee Tech Center India Private Limited

(2025-07)

• Own and manage the comprehensive provider enrollment and onboarding workflows, serving as the central point of contact for network tracking.
• Meticulously audit, verify, and track critical healthcare provider compliance data, including state licenses, DEA certificates, malpractice history, education, and board certifications.
• Leverage Medallion Software to maintain full data integrity, update tracking sheets, and systematically reduce application processing lag times.
• Establish and maintain productive communication pipelines with insurance payers to facilitate swift validation and application status resolutions.

Senior Application Specialist - GeBBS Healthcare Solutions

(2022-07 - 2025-07)

• Successfully coordinated high-volume application preparation and credentialing packets for multiple healthcare practitioners across diverse insurance panels.
• Managed systematic quarterly CAQH re-attestations and profile maintenance to ensure seamless, uninterrupted provider billing privileges.
• Utilized Modio software to monitor dynamic application progression, log critical credentials, and resolve processing bottlenecks.
• Conducted rigorous, proactive telephone and portal follow-ups with key insurance payers to escalate pending provider files.

Customer Service Associate - Tech Mahindra & Q conneqt Business Solutions

(2018-08 - 2022-03)

• Delivered high-quality problem resolution for complex corporate and customer queries, building core communication skills essential for navigating complex payer networks.
• Adhered strictly to rigorous data documentation standards and corporate confidentiality regulations across multi-year project assignments.

B.Tech - Bachelor of Technology - Holy Mary Institute of Technology and Science (2016)

Intermediate - New Chaitanya Junior College (2012)

SSC - Vijay Bharathi Model School (2010)