Medicare/Medicaid Credentialing Specialist (Flexible)

KGF Health LLC; Lahore; Presencial; PKR 600 000 - 1 200 000; Tempo integral

Resumo da oferta

KGF Health LLC is seeking a highly organized Medical Credentialing Specialist to join our revenue cycle management team in Lahore, Pakistan. You will manage the end-to-end credentialing and enrollment for a diverse network of healthcare providers, ensuring compliance and timely payor interactions.

The ideal candidate has hands-on Medicare PECOS and Medicaid enrollment experience, deep CAQH, NPI registry familiarity, and meticulous attention to detail.

Qualificações

• 2–3 years of direct experience in medical credentialing and provider enrollment.
• Mandatory: hands-on Medicare (PECOS) and Medicaid enrollment experience.
• Strong working knowledge of CAQH, NPI, and state medical board licensing.
• Meticulous attention to detail and strong organizational skills.
• Excellent written and verbal communication skills.
• Ability to work independently and navigate payer portals.

Responsabilidades

• Manage the complete credentialing, re-credentialing, and enrollment process for providers with commercial networks and government payers.
• Prepare, submit, and track initial and re-validation applications for Medicare (PECOS) and state Medicaid programs.
• Create, update, and maintain provider profiles in CAQH and the NPPES NPI Registry.
• Monitor application statuses, follow up with insurance payers to resolve delays, and troubleshoot denials or discrepancies.
• Track and maintain provider licenses, DEA certificates, malpractice insurance, and board certifications.
• Maintain accurate provider rosters and internal credentialing databases for clean claim submission.
• Communicate documentation requirements and status updates to providers, practice managers, and insurance representatives.

Conhecimentos

Attention to detail

Organizational skills

Communication skills

Independent work

Payer portals

Formação académica

Certified Provider Credentialing Specialist (CPCS)

Ferramentas

CAQH

PECOS

NPPES/NPI Registry

Credentialing software

Descrição da oferta de emprego

KGF Health LLC is seeking a highly organized Medical Credentialing Specialist to join our revenue cycle management team in Lahore, Pakistan. You will manage the end-to-end credentialing and enrollment for a diverse network of healthcare providers, ensuring compliance and timely payor interactions.

The ideal candidate has hands-on Medicare PECOS and Medicaid enrollment experience, deep CAQH, NPI registry familiarity, and meticulous attention to detail.