Credentialing Specialist

eServMD Pvt Ltd, based in Islamabad, Pakistan, is a service provider catering to US-based companies in sectors such as 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 necessary for completing governmental and commercial payer credentialing applications.
- Keep the internal provider grid accurate and ensure all login credentials are available.
- Update each provider’s CAQH database file promptly according to 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, as well as complete 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:
- 2 to 3 years of prior experience in US medical credentialing.
- Bachelor’s degree in Commerce, Finance, Arts, Pharmacy, Microbiology, or a related field.
- 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.
- Excellent 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.
- Knowledge of data conversion and EMR implementation processes.
- Familiarity with enrollment, credentialing, and EDI & ERA/EFT setup.

Additional Information:
This is a full-time, in-person position with working hours from 6:00 PM to 3:00 AM. The role requires the ability to commute or relocate as necessary. The offered salary range is Rs 1.00 to Rs 2.00 per month.

eServMD Pvt Ltd provides an opportunity to work in a dynamic environment supporting US healthcare operations, with a focus on accuracy, compliance, and collaboration across multiple teams.