Credentialing Specialist

eServMD Pvt Ltd is a service provider company based in Islamabad Pakistan providing services to US-based companies and clients in the field of Electronic Medical Records (EMR), Medical Practice Management, Medical Billing, Real Estate, Accounts & Finance.

We are seeking experienced and detail-oriented Credentialing Executive to join our team.

Primary Responsibilities:

• Maintain individual provider files to include up to date information needed to complete the required governmental and commercial payer credentialing applications
• Maintain internal provider grid to ensure all information is accurate and logins are available
• Update each provider’s CAQH database file timely according to the schedule published by CMS
• Help medical providers to apply or renewal of medical professional licenses; DEA and Controlled Substance etc.
• Complete revalidation requests issued by government payers
• Complete credentialing applications to add providers to commercial payers, Medicare, and Medicaid Complete re-credentialing applications for commercial payers
• Work closely with the Revenue Cycle Director and billing staff to identify and resolve any denials or authorization issues related to provider credentialing
• Maintain accurate provider profiles on CAQH, PECOS, NPPES, and CMS databases

Requirements

• 1-2 years prior Experience in US Medical Credential
• Minimum Bachelor’s Degree in Commerce/Finance/Arts/ Pharmacy/ Microbiology or related
• Excellent in English communication skills both verbal & written, spoken English in American pronunciation is desired
• Good Command over Excel, word and health industry related software tools
• Excellent Organizational, Analytical skills and able to adapt to changing situations
• Proven Knowledge of basic medical terminologies such as coding-ICD10, CPT & HCPC
• Experienced in Managing the Overall Revenue Cycle
• Knowledge about Data Conversion and EMR implementation
• Knowledge about enrollment & credentialing and EDI & ERA/EFT setup

Job Timings: 5:30 PM to 2:30 AM

Job Type: Full-time

Ability to commute/relocate:

• Islamabad: Reliably commute or planning to relocate before starting work (Required)

Job Type: Full-time

Work Location: In person