Credentialing Specialist Medical Billing (US-Healthcare)

Are you an experienced US healthcare professional skilled in provider enrollment and credentialing? MeshSQ is hiring a Credentialing Specialist to manage provider onboarding, insurance paneling, and payer maintenance for our US-based clients.

Key Responsibilities

• Manage end-to-end credentialing, re-credentialing, and enrollment processes for healthcare providers with Medicare, Medicaid, and commercial insurance carriers.

• Setup, update, and maintain provider profiles on CAQH, PECOS, NPI Registry, and state-specific portals.

• Complete and submit accurate provider enrollment applications, group additions, and location updates to insurance payers.

• Follow up with insurance carriers regularly to track application status and resolve processing delays or missing documentation.

• Audit and verify provider credentials including medical licenses, DEA certificates, board certifications, and malpractice coverage for expiration tracking.

• Maintain accurate credentialing tracking databases, fee schedules, and effective enrollment dates within EHR/PM systems.

• Coordinate with client administrative teams to gather required provider documentation and maintain compliance with NCQA and HIPAA standards.

Requirements

• Experience: 2–4+ years of hands-on experience in US Provider Credentialing, Payer Enrollment, and CAQH/PECOS maintenance.

• Domain Knowledge: Solid understanding of NCQA guidelines, commercial payer credentialing workflows, and government (Medicare/Medicaid) enrollment rules.

• Software Skills: Proficiency with credentialing software, EHR/PM platforms, and major payer portals (e.g., Availity, Medicare/Medicaid portals).

• Technical Proficiency: Strong MS Excel skills (data filtering, status tracking, reporting formulas) and high attention to detail.

• Communication: Excellent written and verbal English communication for effective phone and email correspondence with US insurance carriers.

• Education: Bachelor’s degree in Healthcare Administration, Business, or a related field.

Perks & Benefits

• Financial & Growth: Market-competitive salary, performance bonuses, yearly evaluations, and clear career advancement paths.

• Work-Life Balance: Fixed weekends off (Saturday & Sunday).

• Work Culture: Professional working environment with supportive leadership and team culture.

• Employee Amenities: Daily meal allowance/dinner provisions and refreshment breaks.

Application Question(s)

• How much experience do you have as Credentialing Specialist Medical Billing (US-HealthCare)?

• What is your current salary?

• What is your expected salary?

• Do you have to serve any notice period? If yes, How much it would be?

• Our office is located at Lahore Gulberg 2 and it's a night shift job. Will it be feasible for you to commute?

Work Location: In person