credentialing Specialist

7 days ago

Lahore, Punjab, Pakistan Cyber System Full time

2 days ago Be among the first 25 applicants

Direct message the job poster from Cyber System

Human Resources Executive | HR Operations | Compensation & Benefits

We are seeking an experienced Credentials Specialist to join our medical billing team. The successful candidate will be responsible for ensuring that all healthcare providers are properly credentialed and enrolled with payers, in accordance with regulatory requirements and company policies.

Key Responsibilities:
  1. Provider Credentialing: Verify provider credentials, including education, training, licensure, and certification.
  2. Payer Enrollment: Enroll providers with payers, including Medicare, Medicaid, and commercial insurance companies.
  3. Application Preparation: Prepare and submit credentialing and enrollment applications to payers.
  4. Follow-up and Resolution: Follow up with payers to resolve any issues or discrepancies related to credentialing and enrollment.
  5. Maintenance of Credentialing Records: Maintain accurate and up-to-date records of provider credentials and enrollment status.
  6. Compliance: Ensure compliance with regulatory requirements, including HIPAA, OIG, and state-specific laws.
  7. Communication: Communicate with providers, payers, and internal stakeholders to resolve credentialing and enrollment issues.
  8. Data Entry: Accurately enter data into credentialing and billing systems.
Requirements:
  1. Education: High school diploma or equivalent required; associate's or bachelor's degree preferred.
  2. Experience: 2+ years of experience in credentialing, medical billing, or a related field.
  3. Certifications: Certified Provider Credentialing Specialist (CPCS) or Certified Credentialing Specialist (CCS) certification preferred.
  4. Skills: Strong analytical, organizational, and communication skills. Ability to work in a fast-paced environment and meet deadlines.
  5. Software: Proficient in Microsoft Office and credentialing software systems.

If you are a motivated and detail-oriented individual with a passion for credentialing and medical billing, please submit your application, including your resume and cover letter.

Seniority level

Entry level

Employment type

Full-time

Job function

Health Care Provider

Industries

Outsourcing and Offshoring Consulting

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