Credentialing Professional

6 days ago

Lahore, Punjab, Pakistan beBeeCredentialing Full time

We are seeking a skilled professional 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 industry standards.

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.

The ideal candidate will possess a strong passion for credentialing and medical billing, with excellent analytical and problem-solving skills. If you are motivated and detail-oriented, please submit your application, including your resume and cover letter.

Seniority level

Entry level

Employment type

Full-time

Job function

Health Care Provider

Industries

Medical Services

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