Credentialing & Payer Enrollment Executive-Medical Billing
20 hours ago
ob Title: Credentialing Specialist
Location: Wapda Town, Lahore
Organization: One Behavioral Health & Alara Healthcare
About Us
At One Behavioral Health and Alara Healthcare, located in Wapda Town, Lahore, we specialize in delivering high-quality outpatient and inpatient behavioral health services for adults and children across the Houston area. As we continue to expand, we are seeking a detail-oriented and organized Credentialing Specialist who is dedicated to maintaining accuracy, compliance, and excellence in provider credentialing.
Your Role
As a Credentialing Specialist, you will play a critical role in ensuring that all providers remain compliant with payer, hospital, and regulatory requirements. You will manage the full lifecycle of credentialing and re-credentialing, handle provider enrollment, and maintain up-to-date records across multiple systems and payers. Your precision and proactive approach will directly contribute to seamless billing and patient care operations.
Key ResponsibilitiesCredentialing & Compliance
- Maintain and update provider credentialing files for commercial and government payers.
- Manage and monitor CAQH profiles, ensuring compliance with CMS and payer-specific standards.
- Process initial credentialing and re-credentialing applications for Medicare, Medicaid, and private insurance networks.
- Handle applications and renewals for professional licenses, DEA, and controlled substance registrations.
- Complete revalidation processes with government and regulatory programs in a timely manner.
- Coordinate hospital credentialing and manage ongoing provider affiliations and privileges.
Collaboration & Support
- Work closely with the Revenue Cycle Director and Billing Team to address credentialing-related denials, payer issues, and authorization challenges.
- Ensure accuracy of provider data across CAQH, PECOS, NPPES, and CMS databases.
- Maintain a centralized internal credentialing grid, including provider credentials, renewal dates, and login details.
- Provide administrative and operational support for credentialing activities and audits as needed.
Ideal Candidate Profile
- Strong understanding of healthcare credentialing standards and payer requirements.
- Excellent organizational skills with high attention to detail and accuracy.
- Proficient in managing multiple credentialing platforms (CAQH, PECOS, NPPES, etc.).
- Ability to work independently while collaborating effectively with internal teams.
Job Type: Full-time
Pay: Rs45, Rs80,000.00 per month
Ability to commute/relocate:
- Wapda Town: Reliably commute or planning to relocate before starting work (Required)
Application Question(s):
- Willing to work the night shift?
Experience:
- Credentialing: 1 year (Preferred)
Language:
- English (Required)
Work Location: In person
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