Credentialing Specialist

6 days ago

Karachi, Sindh, Pakistan Mayatax Full time
Credentialing Specialist

Maya & Associates has been providing bookkeeping, accounting, and finance solutions to individuals and businesses for the last 3 decades. We offer a wide range of services for small to mid-sized businesses, including Business Plans, Bookkeeping, HR, and Payroll Services, and State and Federal Income Taxes across all 50 states. Our core mission is to help clients achieve their goals by providing top-quality professional services.

Role Description

This is a full-time remote role for a Credentialing Specialist at Maya & Associates. The Credentialing Specialist will be responsible for managing credentialing processes, communicating with staff, providing excellent customer service, and ensuring compliance with Medicare regulations.

Responsibilities

  1. Oversee initial credentialing and re-credentialing processes for healthcare providers.
  2. Manage the payor enrollment process, ensuring accuracy and adherence to deadlines.
  3. Collect and verify required documentation, including licenses, certifications, education, training, and references.
  4. Audit reports to ensure compliance with organizational policies and regulatory standards.
  5. Submit, track, and follow up on credentialing and payor enrollment applications.
  6. Maintain an up-to-date database of provider credentials and enrollment statuses.
  7. Collaborate with internal teams such as HR, legal, and clinical staff to streamline credentialing processes.
  8. Serve as the primary point of contact for providers regarding credentialing and enrollment-related inquiries.
  9. Address and resolve discrepancies or disputes related to credentialing and payor enrollment.
  10. Credentialing and Medical Staff Credentialing skills.

Requirements:

  1. 3-5 years in credentialing, specifically with commercial and Medicaid processes.
  2. Bachelor's degree in Healthcare Administration or related field is a plus.
  3. Previous experience in hospital credentialing or behavioral healthcare is a plus.
  4. Proficient in MS Office, particularly Excel.
  5. Knowledge of Medicare regulations.
  6. Ability to multitask and manage multiple projects simultaneously.
  7. Effective communication skills for internal and external interactions.
  8. Must be fluent in English.
  9. Punctual and detail-oriented.
  10. Willing to work onsite in Karachi as per CST hours.
Seniority level

Mid-Senior level

Employment type

Full-time

Job function

Health Care Provider

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