Credentialing/Senior Credentialing Specialist

3 days ago

Rawalpindi, Punjab, Pakistan Culture@Roots Full time 900,000 - 1,200,000 per year

We are actively seeking a
Credentialing Specialist
with diversified experience in
Credentialing, State Licensing, Accreditation, and Certification processes. The ideal candidate will have a well-rounded background managing various provider and facility compliance requirements, ensuring accuracy and regulatory alignment across multiple functions.

Core Responsibilities:

Credentialing:

  • Manage provider and facility credentialing across various payer systems.
  • Ensure compliance with payer, federal, and state regulations.
  • Maintain credentialing databases and conduct regular audits.

State Licensing:

  • Prepare, submit, and manage state license applications and renewals.
  • Track expiration dates and coordinate timely renewals.
  • Liaise with state agencies to resolve licensing issues.

Certification & Accreditation:

  • Coordinate facility certification and accreditation processes (e.g., JCAHO, NCQA, CMS).
  • Prepare documentation, manage submissions, and follow through on compliance requirements.
  • Assist with audits and maintain up-to-date accreditation records.

Ideal Candidate Profile:

  • Minimum 2–3 years of experience handling credentialing, state licensing, accreditation, and certification tasks.
  • Strong understanding of healthcare regulatory requirements and payer enrollment processes.
  • Ability to manage multiple tasks and maintain meticulous records.
  • Experience with credentialing software platforms (CAQH, PECOS, etc.) is a plus.
  • Strong communication, organizational, and problem-solving skills.

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