Provider Credentialing Expert

1 day ago


Karachi, Sindh, Pakistan Mayatax Full time

About Us

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Maya & Associates has been providing high-quality bookkeeping, accounting, and finance solutions to individuals and businesses for over three decades. Our team of experts offers a wide range of services, including Business Plans, Bookkeeping, HR, Payroll Services, and State and Federal Income Taxes across all 50 states.

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Job Description

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The Credentialing Specialist will be responsible for managing credentialing processes, communicating with staff, and providing excellent customer service. They must also be knowledgeable about Medicare regulations and able to work independently.

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Main Responsibilities

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

Requirements

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  1. 3-5 years of experience in credentialing, specifically with commercial and Medicaid processes.
  2. Bachelor's degree in Healthcare Administration or a 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. Fluency in English.
  9. Punctual and detail-oriented.
  10. Willingness to work onsite in Karachi as per CST hours.


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