Credentialing Specialist - For Behavioural Health Providers and Therapist USA

Boston Neurobehavioral Associates

Karachi , Pakistan

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Citadel Healthcare Management (PVT) LTD. is a healthcare management services provider supporting medical practices across North America. Our team collaborates across multiple disciplines to handle a variety of administrative tasks within the healthcare sector. We are dedicated to offering employees meaningful opportunities to apply their skills, advance their careers, and contribute to the company’s success. At Citadel, we foster a supportive, inclusive, and motivating work environment where every team member’s contribution is valued and recognized. Diversity and inclusion are central to our culture, welcoming individuals from all backgrounds and encouraging innovation, teamwork, and continuous professional growth.

Key Responsibilities

- Manage the complete credentialing and re-credentialing process for behavioral health providers and therapists.
- Prepare, review, and submit applications to insurance panels, Medicaid/Medicare, and other payer networks.
- Verify provider qualifications, licenses, certifications, and conduct background checks.
- Maintain accurate credentialing records in compliance with NCQA (National Committee for Quality Assurance) standards and CMS (Centers for Medicare & Medicaid Services) regulations.
- Track application statuses, follow up with payers, and resolve any discrepancies.
- Collaborate with HR, compliance, and clinical teams to ensure timely onboarding of providers.
- Monitor expiration dates of licenses, certifications, and re-credentialing deadlines to maintain compliance.

Required Qualifications

- Bachelor’s degree in Healthcare Administration, Business, or a related field is preferred.
- 2 to 4 years of experience in healthcare credentialing, ideally within behavioral health or outpatient settings.
- Strong knowledge of insurance payer requirements, CAQH, NPI, and credentialing standards.
- Excellent organizational skills with a keen attention to detail and ability to meet deadlines.
- Strong communication and problem-solving skills.
- Proficiency in credentialing software and Microsoft Office Suite.

Preferred Qualifications and Benefits

- Competitive salary package.
- Health insurance coverage.
- Paid time off and recognized holidays.
- Opportunities for professional growth and career advancement.
- Supportive, mission-driven work environment focused on employee development.
- This position requires working from the office only.

Citadel Healthcare Management is committed to empowering its employees through teamwork, innovation, and continuous learning, ensuring a rewarding and dynamic workplace for all.