Credentialing Lead – Behavioral Health

Prima Systems

Posted 16 hours ago 36 views Report Job

PKR. 100,000 - 125,000/Month

Key Responsibilities:

Lead day-to-day credentialing operations for behavioral health professionals, including therapists, psychiatrists, psychologists, and counselors.
Manage the credentialing and re-credentialing processes in accordance with NCQA, CMS, and state-specific regulations.
Review provider applications, verify qualifications, and ensure completion of credentialing files.
Liaise with payers and health plans to facilitate provider enrollment and maintain active status.
Supervise and train credentialing staff, ensuring team performance goals are met.
Maintain accurate and up-to-date provider databases and credentialing systems.
Track license expirations, malpractice insurance, and other required documentation.
Collaborate with internal departments (HR, Compliance, Provider Relations) for onboarding and audit readiness.
Generate reports and present credentialing metrics and status updates to management.
Respond to internal and external inquiries regarding credentialing status and policies.

Requirements:

Bachelor’s degree.
Strong knowledge of NCQA, CMS, and state-specific credentialing standards.
Excellent organizational, analytical, and communication skills.
Proficiency with credentialing software and provider databases.
Ability to lead a team and manage multiple priorities in a fast-paced environment.

Experience:

2–3 years of experience in credentialing within a behavioral health setting.
Previous experience leading or supervising a credentialing team is preferred.

Skills

CMS NCQA Provider Enrollment Credentialing Skills

Job Details

Industry:

BPO

Functional Area:

Client Services & Customer Support

Total Positions:

1 Post

Job Shift:

Third Shift (Night)

Job Type:

Full Time/Permanent

Department:

Operations

Job Location:

Lahore, Pakistan

Gender:

No Preference

Minimum Education:

Bachelors

Career Level:

Experienced Professional

Experience:

2 Years - 3 Years

Apply Before:

Jun 03, 2025

Posting Date:

May 03, 2025

Prima Systems enables its clients over the whole Enterprise Technology to stack with separated industry arrangements. We modernize Business Process Outsourcing and make everything secure, adaptable and coordinated across open, private and half mists. Partnership is at our core. Our client relationships are about more than just the work we do, they are a huge part of who we are. At BPO Bench, we consider the success of our clients as a barometer of how successful we are. The Enterprise Technology Stack incorporates IT Outsourcing, Cloud and Security, Applications, Analytics and Engineering. We join long periods of experience running crucial frameworks with the most recent advanced developments to convey better business results and new degrees of execution, intensity and encounters for our clients and their partners. Prima Systems puts resources into three key drivers of development: People, Customers and Operational Execution. Our broad network helps drive coordinated effort and influence innovation freedom.