Credentialing Specialist

CodeCure AI is seeking a detail-oriented Credentialing Specialist to join our team in Gulberg Green, Islamabad. The ideal candidate will have a strong background in insurance credentialing, provider enrollment, and regulatory compliance. This role requires confidence in managing multiple credentialing portals and working closely with various payers to ensure providers are properly enrolled and compliant with industry standards.

Key Responsibilities:
- Manage and maintain CAQH, NPPES, and PECOS portals efficiently.
- Submit credentialing applications and DEA registrations, ensuring timely follow-up.
- Enroll providers for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) with insurance payers.
- Coordinate with Medicare, Medicaid, and commercial insurance companies to facilitate provider network participation.
- Maintain accurate and organized credentialing records to support compliance and auditing processes.
- Follow up regularly with payers to monitor and update provider network status.

Required Qualifications:
- 2 to 3 years of experience in credentialing, specifically within Medical and Behavioral Health sectors.
- Practical experience using CAQH, PECOS, NPPES, and other relevant credentialing portals.
- Solid knowledge of provider licensing requirements, DEA registrations, and board certifications.
- Excellent communication skills paired with strong attention to detail and organizational abilities.

This position offers an excellent opportunity to work in a dynamic environment where your expertise in credentialing will directly impact provider network integrity and compliance. If you are a proactive professional with a passion for accuracy and regulatory adherence, this role is well-suited for you.