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Muhammad Toqeer Rath

@muhammadtoqeerrath

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Credentialing and Enrollment Team Lead at Transcure, overseeing Medicare and Medicaid enrollment across 14 states.

Pakistan

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At Transcure, I supervise end-to-end credentialing and enrollment operations for medical, behavioral health, dental, and group practice providers. I oversee Medicare and Medicaid credentialing across 14 states and direct primary source verification for provider credentials.

I also lead and mentor a credentialing team, maintain CAQH updates and re-attestations, and present performance metrics and process insights to senior management. Earlier at Transcure and Physicians Revenue Group, I completed provider enrollment, re-credentialing, demographic updates, and ERA enrollment.

Experience

Work history, roles, and key accomplishments

Current

Senior Credentialing & Enrollment Team Lead

Current

Transcure

Feb 2025 - Present (1 year 7 months)

Supervise end-to-end credentialing and enrollment operations for medical, behavioral health, dental, and group practice providers. Oversee Medicare and Medicaid credentialing across 14 states and direct primary source verification for licenses, NPI, DEA, and board certifications.

Provider Enrollment Credentialing Medicare Medicaid Primary Source Verification CAQH NPI Dea Hospital Medical Staff Privileges Team Leadership Workflow Optimization CMS HIPAA

Credentialing Team Lead

Transcure

Nov 2023 - Jan 2025 (1 year 2 months)

Maintained and audited individual provider files, ensuring accurate documentation and system access. Completed credentialing and enrollment applications for new providers across multiple states and payer types, and managed ERA, EFT, and EDI enrollments.

Credentialing Provider Enrollment ERAs EFT EDI Availity NGS Connex UHC Provider Portal Trizetto Payspan Simple Practice DME Enrollment Recredentialing

Sr. Credentialing Specialist

Transcure

Dec 2022 - Oct 2023 (10 months)

Managed end-to-end provider credentialing and enrollment with commercial insurance payers, following up via calls and payer web portals. Prepared and submitted credentialing applications ensuring accuracy and compliance with payer guidelines.

Credentialing Provider Enrollment Commercial Insurance ERA Enrollments Payer Portals Compliance

Credentialing Executive

Physicians Revenue Group

Oct 2019 - Nov 2022 (3 years 1 month)

Maintained and updated provider records including NPI Type 1 and Type 2, state licenses, and supporting documentation. Completed credentialing and enrollment applications for providers and groups with commercial insurance.

Credentialing Provider Enrollment NPI State Licensing ERA Enrollments Commercial Insurance