Credentialing Executive

eServMD Pvt Ltd, based in Islamabad, Pakistan, is a service provider catering to US-based companies and clients across various sectors including Electronic Medical Records (EMR), Medical Practice Management, Medical Billing, Real Estate, and Accounts & Finance. We are currently looking for a detail-oriented and experienced Credentialing Executive to join our team. This role involves managing provider credentialing processes to ensure compliance with governmental and commercial payer requirements, supporting medical providers with licensing, and collaborating with internal teams to resolve credentialing-related issues.

Key Responsibilities:
- Maintain individual provider files with up-to-date information required for governmental and commercial payer credentialing applications.
- Manage and update the internal provider grid to ensure accuracy and availability of login credentials.
- Timely update each provider’s CAQH database file in accordance with CMS schedules.
- Assist medical providers in applying for or renewing professional licenses, including medical licenses, DEA, and Controlled Substance registrations.
- Complete revalidation requests issued by government payers.
- Prepare and submit credentialing applications to add providers to commercial payers, Medicare, and Medicaid; handle re-credentialing applications for commercial payers.
- Collaborate closely with the Revenue Cycle Director and billing staff to identify and resolve denials or authorization issues related to provider credentialing.
- Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases.

Required Qualifications:
- 1-2 years of prior experience in US Medical Credentialing.
- Minimum Bachelor’s Degree in Commerce, Finance, Arts, Pharmacy, Microbiology, or related fields.
- Excellent English communication skills, both verbal and written; proficiency in American English pronunciation is preferred.
- Strong command of Microsoft Excel, Word, and health industry-related software tools.
- Exceptional organizational and analytical skills with the ability to adapt to changing situations.
- Proven knowledge of basic medical terminologies including coding systems such as ICD-10, CPT, and HCPCS.
- Experience managing the overall revenue cycle.
- Understanding of data conversion processes and EMR implementation.
- Knowledge of enrollment and credentialing processes, as well as EDI and ERA/EFT setup.

Additional Information:
This is a full-time position with working hours from 5:30 PM to 2:30 AM. The role requires the candidate to reliably commute or plan to relocate to Islamabad before starting work. The position is based on-site at the company’s Islamabad office. Compensation starts from Rs1.00 per month.

We seek a motivated professional who can contribute effectively to our credentialing operations while maintaining accuracy and compliance with industry standards. If you meet the qualifications and are ready to work in a dynamic environment, this opportunity offers a platform to grow your career in the medical credentialing field.