Credentialing & Medical Billing

The Credentialing Specialist is responsible for overseeing the full provider credentialing and re-credentialing process across multiple insurance networks, payers, and credentialing systems. This role requires a highly organized and detail-focused professional with strong follow-up and coordination skills to ensure continuous regulatory compliance, uninterrupted provider participation, and efficient billing and authorization operations. The position plays an essential role in maintaining operational effectiveness and supporting accurate, timely reimbursements.

Key ResponsibilitiesCredentialing & Compliance

• Maintain, organize, and routinely update provider credentialing records for both government and commercial insurance payers.
• Manage CAQH profiles and ensure compliance with CMS regulations and payer-specific credentialing requirements.
• Process initial credentialing, re-credentialing, and payer enrollment applications for Medicare, Medicaid, and private insurance networks.
• Handle applications, renewals, and documentation related to professional licenses, DEA registrations, and controlled substance certifications.
• Complete provider revalidation processes with regulatory and government agencies within established deadlines.
• Coordinate hospital credentialing activities, including provider privileges and ongoing hospital affiliations.

Collaboration & Operational Support

• Work closely with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer issues, and authorization delays.
• Ensure provider information remains accurate and consistent across CAQH, PECOS, NPPES, CMS databases, and internal credentialing systems.
• Maintain a centralized credentialing tracker containing provider credentials, expiration dates, payer participation status, and system access details.
• Provide administrative and documentation support for credentialing audits, compliance reviews, and regulatory requirements as needed.

Pay: Rs40,000.00 - Rs70,000.00 per month

Ability to commute/relocate:

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

Application Question(s):

• Willing to work the night shift in Wapda Town, Lahore

Experience:

• Medical Billing: 1 year (Preferred)

Language:

• English (Required)

Work Location: In person