Credentialing Executive

The Credentialing Executive is responsible for managing and processing credentialing applications for healthcare providers. This includes verifying qualifications, licenses, certifications, and work history to ensure compliance with industry standards and regulatory requirements.

Key Responsibilities:

Process and manage credentialing and re-credentialing applications for healthcare providers.
Verify provider qualifications, education, training, licensure, board certification, work history, and malpractice history.
Maintain up-to-date knowledge of payer requirements and accreditation standards (e.g., NCQA, CMS).
Communicate with providers, insurance companies, and regulatory bodies to collect and validate credentialing information.
Enter and update data in credentialing databases or software systems.
Track license and certification renewals to ensure continuous provider eligibility.
Assist in audits and respond to inquiries related to credentialing.
Maintain confidentiality of provider data and follow data protection protocols.
Support onboarding of new providers by ensuring timely and accurate credentialing.
Prepare status reports and update stakeholders on credentialing progress.

Requirements:

Bachelor's degree in Healthcare Administration, Business, or related field (preferred).
1–3 years of experience in credentialing, provider enrollment, or a healthcare-related role.
Knowledge of credentialing standards and insurance payer requirements.
Proficiency in credentialing software and Microsoft Office tools.
Strong attention to detail and organizational skills.
Excellent verbal and written communication.
Ability to handle sensitive information with discretion.

Preferred Skills:

Experience with CAQH, PECOS, or similar credentialing platforms.
Familiarity with healthcare compliance regulations.
Ability to multitask and meet deadlines in a fast-paced environment.

技能

Documents Verification Data Management MS Excel

工作详细内容

全部职位:

1 发布

工作时间:

早班

工作类型:

全职/长期工

工作地址:

拉合尔, 巴基斯坦

性别:

没有偏好

最低学历:

学士

职位等级:

资深专业人员

经验:

1年 - 3年

在之前申请:

Jun 06, 2025

发布日期:

May 05, 2025

Cyber System (Pvt) Ltd

· 101-200 员工 - 拉合尔

关注

Cyber System is a US based organisation, established in 2008, is a leader in customized outsource Software development, Medical Billing, Recruitment solutions, research and human resource services representing clients throughout the world. The core philosophy behind Cyber System is to tackle the business problems and create novel and efficient solutions by utilizing state-of-the-art technology. Cyber System believes in professionalism, business ethics and morality. It aims at long-term relationships based on trust, understanding and good will. Business criteria at Cyber System are many as opposed to profit alone. Here, commitment, sincerity and enthusiasm form the path to professionalism. Effective and regular communication and sanctity of timelines is very important to Cyber System. This leads to the satisfaction of both the Cyber System Team and Cyber System Clients. Aspiring to expand to new sectors, Cyber System aims at rendering its services to many new markets both national and international.