Credentialing Specialist

CodeCure AI is seeking a detail-oriented Credentialing Specialist based in Gulberg Green, Islamabad. The ideal candidate will have a strong background in managing insurance credentialing processes, provider enrollment, and ensuring compliance with regulatory requirements. This role demands confidence in navigating multiple credentialing portals and collaborating with various healthcare payers to maintain accurate and up-to-date provider information.

Key Responsibilities:
- Manage and maintain CAQH, NPPES, and PECOS portals efficiently.
- Submit credentialing and DEA registration applications and conduct timely follow-ups.
- Enroll healthcare providers for Electronic Remittance Advice (ERA) and Electronic Funds Transfer (EFT) with insurance payers.
- Coordinate credentialing activities with Medicare, Medicaid, and commercial insurance companies.
- Maintain organized and accurate credentialing records to ensure compliance and readiness for audits.
- Follow up with payers to monitor and update provider network status regularly.

Required Qualifications:
- 2 to 3 years of experience in credentialing, specifically within Medical and Behavioral Health sectors.
- Practical experience working with CAQH, PECOS, NPPES, and similar credentialing portals.
- Solid understanding of provider licensing requirements, DEA registrations, and board certifications.
- Excellent communication skills paired with a keen attention to detail to manage complex credentialing tasks effectively.

This position offers the opportunity to work in a dynamic environment where accuracy and compliance are critical to the organization’s success. Candidates with a proactive approach and the ability to manage multiple credentialing processes simultaneously will thrive in this role.