Posted Sep 25, 2026 17 views
Meds IT Nexus Pvt. Ltd. is seeking a detail-oriented Credentialing Audit Specialist to join our team on a full-time, on-site basis. This role involves working evening and night shifts from 5:30 PM to 2:30 AM, Monday through Friday, at our office located on Asghar Mall Road, Rawalpindi. The ideal candidate will be responsible for ensuring accuracy and compliance in provider credentialing processes for our US-based healthcare clients, focusing on quality control, audits, and payer enrollment verification.
Key Responsibilities
- Perform thorough quality and compliance audits on provider credentialing applications, re-credentialing files, and payer enrollment packages.
- Verify the accuracy and validity of provider documentation, including medical licenses, NPI records, DEA certificates, malpractice insurance, and board certifications.
- Audit submissions and enrollment statuses within payer portals, ensuring proper contract setup across Medicare, Medicaid, and commercial insurance networks.
- Identify errors, gaps in work history, compliance risks, or process inefficiencies, and implement timely corrective actions.
- Monitor credentialing timelines closely to reduce billing delays and prevent out-of-network claim denials.
- Maintain detailed audit logs and generate weekly and monthly compliance reports, presenting findings to leadership and client managers.
- Ensure strict adherence to CAQH profiles, PECOS enrollment guidelines, state-specific regulations, and HIPAA compliance standards.
Required Qualifications
- Minimum of 2 to 3 years of hands-on experience in US Provider Credentialing, Payor Enrollment, and Quality Auditing.
- Strong knowledge of CAQH, PECOS, NPPES, NPI registry, primary source verification, and major US commercial and government payer processes.
- Exceptional analytical skills with a high attention to detail and advanced proficiency in MS Excel and Revenue Cycle Management (RCM) database tools.
- Excellent written and verbal communication skills in English to effectively report audit findings and collaborate with team members.
- Bachelor’s degree in Healthcare Administration, Business, or a related field.
Preferred Qualifications and Benefits
- Competitive salary aligned with market standards, including inflation bonuses, HR performance bonuses, regular salary increments, and participation in a Contributory Savings Plan (CSP).
- Fixed weekends off (Saturday and Sunday) with paid leave options and leave encashment available to support work-life balance.
- Comprehensive medical coverage, annual company-sponsored trips, complimentary dinners, and daily tea/green tea breaks to promote employee well-being.
- Dedicated transportation allowance specifically provided for female employees to ensure safe and convenient commuting.
Candidates should be prepared to answer questions regarding their experience as a Credentialing Audit Specialist, current and expected salary, notice period requirements, and their ability to commute to the night shift location at Asghar Mall, Murree Road, Rawalpindi. This position requires in-person attendance during the specified shift hours.
If you are a compliance-focused professional with a passion for accuracy and quality in healthcare credentialing, Meds IT Nexus offers an excellent opportunity to grow your career in a supportive and dynamic environment.
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Meds IT Nexus
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