Credentialing & Enrollment executive-Medical Billing
6 days ago
About Us
One Behavioral Health and Alara Healthcare, located in Wapda Town, Lahore, provide high-quality outpatient and inpatient behavioral health services for adults and children across the Houston area. As our organization continues to grow, we are seeking a highly organized and detail-oriented Credentialing Specialist who is committed to accuracy, compliance, and supporting a seamless healthcare delivery process.
Your Role
As a Credentialing Specialist, you will be responsible for managing the complete credentialing and re-credentialing lifecycle for providers across multiple networks and systems. Your role ensures that all providers remain compliant with payer, regulatory, and hospital requirements. Your attention to detail, proactive approach, and strong follow-up skills will directly support efficient billing operations, timely authorizations, and high-quality patient care.
Key ResponsibilitiesCredentialing & Compliance
- Maintain, update, and organize provider credentialing files for both commercial and government payers.
- Manage and oversee CAQH profiles, ensuring alignment with CMS and payer-specific compliance standards.
- Process initial credentialing and re-credentialing applications for Medicare, Medicaid, and private insurance networks.
- Handle applications and renewals for professional licenses, DEA registration, and controlled substance permits.
- Complete revalidation processes for government and regulatory programs within required timelines.
- Coordinate hospital credentialing, manage provider privileges, and maintain ongoing affiliations.
Collaboration & Support
- Collaborate with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials and authorization issues.
- Ensure all provider information is accurate and consistent across CAQH, PECOS, NPPES, CMS databases, and internal systems.
- Maintain an internal credentialing grid containing provider credentials, expiration dates, and login details.
- Provide administrative support for credentialing audits, compliance checks, and related documentation as needed.
Ideal Candidate Profile
- Strong understanding of healthcare credentialing standards and payer requirements.
- Exceptional organizational skills with a high level of accuracy and attention to detail.
- Experience working with credentialing platforms such as CAQH, PECOS, and NPPES.
- Ability to manage multiple tasks independently while collaborating effectively with various teams.
Job Type: Full-time
Pay: Rs45, Rs70,000.00 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 in Wapda Town, Lahore?
Experience:
- Medical Billing: 1 year (Preferred)
Language:
- English (Required)
Work Location: In person
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Wapda Town, Pakistan Macrise Tech Solutions Full time 360,000 - 720,000 per yearob Title: Credentialing SpecialistLocation: Wapda Town, LahoreOrganization: One Behavioral Health & Alara HealthcareAbout UsAt 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...
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