Healthcare Provider Enrollment Specialist

18 hours ago


Islamabad, Islamabad, Pakistan beBee Careers Full time
Job Description:

This role involves handling credentialing for healthcare providers specializing in psychiatry and behavioral health services. The successful candidate will oversee the full Medicare enrollment process, ensuring compliance with guidelines. They will verify provider credentials and maintain accurate records, monitor compliance with regulations, and address policy updates.

The Credentialing Specialist will be responsible for managing hospital credentialing, collecting and verifying necessary documentation, facilitating background checks, and determining hospital privileges based on qualifications. They will also manage commercial insurance enrollments, verifying provider documentation, updating CAQH profiles, and submitting applications within a specified timeframe.

Key Responsibilities include overseeing the full Medicare enrollment process, ensuring compliance with CMS guidelines, monitoring compliance with Medicare regulations, and addressing any policy updates. Additional responsibilities include completing and submitting CMS-855I, 855B, and 855R applications as appropriate, ensuring 100% accuracy in application submissions to avoid delays, and managing address updates and location-based enrollments across multiple states.



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