Credentialing Manager

Remotedxb; Dubai; On-site; AED 250,000 - 320,000; Full time

Benefits offered by this job

Medical insurance

Vision insurance

Dental insurance

401(k) plan with matching

Paid Time Off

Commuter benefits

Job summary

Remotedxb is seeking a credentialing leader in Dubai to oversee provider file governance, audits, and regulatory alignment across major plans and state licenses.

The role requires deep healthcare credentialing expertise, supervisory experience, and strong collaboration with Compliance, Billing, Legal, and Clinical teams to resolve denials and ensure data integrity.

Qualifications

• Minimum 6+ years in healthcare credentialing.
• 1–2 years in a supervisory or lead specialist role.
• Mastery of CAQH, PECOS, and standard credentialing software.

Responsibilities

• Maintain alignment with NCQA, URAC, Joint Commission, CMS, and state regulatory guidelines.
• Design, implement, and audit internal quality control processes to ensure zero gaps in provider files.
• Lead coordinator for all external facility and plan audits.
• Manage relationships with major commercial insurance plans, Medicare, and Medicaid.
• Monitor KPIs like Days to Enroll and resolve complex application rejections.
• Collaborate with Compliance, Billing, Legal, Clinical and Revenue operations teams to troubleshoot claim denials.
• Oversee the accuracy and security of the credentialing database.
• Ensure CAQH profiles, NPPES data, and state license renewals are updated systematically.

Skills

Attention to detail

Verbal communication

Administrative skills

Supervisory experience

Education

Bachelor’s degree in Healthcare Admin

Tools

CAQH

PECOS

Credentialing software

Job description

Responsibilities

• Maintain strict alignment with NCQA, URAC, Joint Commission, CMS, and state regulatory guidelines
• Design, implement, and audit internal quality control processes to ensure zero gaps in provider files
• Serve as the lead coordinator for all external facility and plan audits
• Manage relationships with major commercial insurance plans, Medicare, and Medicaid
• Monitor key performance indicators (KPIs) like "Days to Enroll" and resolve complex application rejections
• Collaborate with Compliance, Billing, Legal, Clinical and Revenue operations teams to troubleshoot claim denials
• Oversee the accuracy and security of the credentialing database
• Ensure CAQH profiles, NPPES data, and state license renewals are updated systematically
• Oversee the full lifecycle of state-level licensing, including medical boards, DEA, and facility-level DME licenses

Requirements

• Minimum of 6+ years of healthcare credentialing experience
• 1–2 years in a supervisory or lead specialist role
• CPCS (Certified Provider Credentialing Specialist) or CPMSM (Certified Professional Medical Services Management) required
• Mastery of CAQH, PECOS, and standard credentialing software
• Bachelor’s degree in Healthcare Administration, Business Administration, or related field preferred
• Exceptional attention to administrative detail and strong verbal communication skills

Benefits

• Medical, vision, and dental insurance
• Medical and dependent care FSA options
• 401(k) plan with matching contributions
• Paid Time Off
• Commuter benefits (Seattle-based employees)