Medical Credentialing Expert

7 days ago

Karachi, Sindh, Pakistan beBee Careers Full time
Job Description:

A Medical Credentialing Expert is required to perform all aspects of credentialing and re-credentialing of health care professionals.

Key Responsibilities:
  • Credentialing Process Management: Perform the credentialing process for medical and behavioral providers, including contracting, and ensure timely completion through frequent follow-ups.
  • CAQH Attestation and Confidentiality: Attest to CAQH and maintain confidentiality in communications.
  • Effective Communication: Communicate effectively with stakeholders, both orally and in writing.
  • Portal Creation and EHR Management: Create insurance portals and manage electronic health records (EHR/EMR) systems.
Requirements:
  • Credentialing Knowledge: Possess knowledge of medical provider credentialing and accreditation principles, policies, processes, procedures, and documentation.
  • Professional Experience: Proven experience as a Medical Biller in a US healthcare setting or similar role.
  • Software Proficiency: Proficiency in medical billing software and EHR/EMR systems.
  • Terminology and Billing: In-depth knowledge of medical terminology, coding (CPT, ICD-10, HCPCS), and insurance billing procedures.
Qualifications:
  • Organizational Skills: Excellent organizational and time management skills.
  • Multitasking: Able to multitask and prioritize tasks effectively.
  • Communication Skills: Strong verbal and written communication skills.
  • Degree Requirement: Bachelor's degree in business administration or related field.
About This Role:

This position requires independence but frequent coordination with other team members. The ideal candidate should have 2 to 3 years of experience and knowledge of Medicare, Medicaid, IPAs & Medicare Advantage plans. Proficiency in Microsoft Office Suite is also required. A detail-oriented mindset and ability to work efficiently in a fast-paced environment are essential.

A strong understanding of healthcare compliance and privacy regulations (HIPAA) is crucial for success in this role. If you possess the necessary skills and qualifications, we encourage you to apply.

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