Mid-Career Credentialing Specialist

Residents of Bahria Town, DHA, Humak, and Askari 14 in Rawalpindi are preferred candidates due to the proximity of the office location. This is a full-time, in-person position based at Bahria Town Phase 7, Rawalpindi. The ideal candidate will have 4 to 5 years of relevant experience.

Sequel Technologies is a software company specializing in healthcare IT and medical billing services for the US market. We are currently looking for a Credentialing Specialist to oversee provider credentialing and payer enrollment processes with Medicare, Medicaid, and commercial insurance payers. The role requires managing applications, maintaining provider profiles, and ensuring compliance with payer guidelines and company policies.

Key Responsibilities:
- Manage provider credentialing, payer enrollment, recredentialing, and revalidation processes.
- Prepare, submit, and track applications with Medicare, Medicaid, and commercial payers.
- Maintain accurate provider profiles in CAQH, PECOS, NPPES, and various payer portals.
- Collect and verify provider licenses, certifications, malpractice insurance, and other required documentation.
- Follow up with payers regarding application status, missing information, and enrollment issues.
- Maintain up-to-date provider records and enrollment information.
- Monitor credential and license expiration dates to ensure timely renewals.
- Verify payer participation, effective dates, and provider affiliations.
- Coordinate effectively with providers, practice managers, payers, and internal teams.
- Assist with Electronic Data Interchange (EDI) and Electronic Remittance Advice/Electronic Funds Transfer (ERA/EFT) enrollment as needed.
- Ensure compliance with HIPAA regulations and company policies throughout all processes.

Required Qualifications:
- Bachelor’s degree or equivalent professional experience.
- 4 to 5 years of experience in US healthcare provider credentialing and payer enrollment.
- Strong knowledge of Medicare, Medicaid, and commercial payer credentialing processes.
- Proficiency with CAQH, PECOS, NPPES, and payer portals.
- Excellent attention to detail, organizational skills, and ability to communicate and follow up effectively.

Preferred Qualifications and Benefits:
Candidates residing in Bahria Town Phase 7/8 or DHA 1/2 Rawalpindi are preferred due to the office location. The position offers a competitive benefits package including healthcare coverage (both outpatient and inpatient), entertainment allowance, cellular allowance, and provident fund contributions.

Work Schedule:
- Summer hours: 5:00 PM to 2:00 AM
- Winter hours: 6:00 PM to 3:00 AM

Applicants should be comfortable working onsite during these hours and be able to commute to the office location. Immediate availability is highly preferred as this position needs to be filled urgently.

Interested candidates will be asked about their comfort with the working hours, residency proximity, expected and current salary, willingness to work onsite, ability to start immediately, and commute feasibility.

This role offers an excellent opportunity for professionals with a strong background in healthcare credentialing to join a growing company focused on the US healthcare market.