data analyst

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associate sqa engineer

credentialing analyst

Hiffey

Claims Med pioneers in Medical Billing for Healthcare providers in the United States. We are looking for fresh, energetic individuals who can not only add value to our firm, but also find endless opportunities in a growing firm. We are currently hiring individuals for our credentialing teams and looking for candidates(Preferably males) who are willing to learn and apply themselves in a short period of time- No Experience required.Job Description: Prepare, submit and track provider credentialing and re-credentialing applications. Maintain accurate provider information in CAQH, NPPES, PECOS and payer portals. Verify provider credentials Ensure compliance Coordinate site visits, address corrections and contract amendments as required by payers Maintain credentialing databases, spreadsheets and audit-ready files. Communicate regularly with providers, practice managers and insurance representatives regarding credentialing status Support facility credentialing and payer enrollment for new locations. Prepare reports on credentialing timelines, approvals, denials, and expirationsRequirements Night shift availability (7pm to 4am) Mondays to Fridays Graduation (required) English Proficiency is mustLocation Shaheed-e-Millat Rd, Karachi Paid training will be provided. Finalists will begin a 3-month probation period and will be re-evaluated before becoming permanent employees. Permanent employees enjoy several performance, and punctuality based bonuses, along with other perks.Please submit your resumes at hr@claimsmed.com and begin your journey of becoming an integral part of the Claims Med family.Job Type: Full-timePay: Rs40,000.00 - Rs45,000.00 per monthWork Location: In person

Credentialing Analyst

claimcare

<ul><li>Ensure ongoing compliance with regulatory standards, such as those set by the National Committee for Quality Assurance (NCQA). specific actions or procedures related to compliance.</li><li>Efficiently perform all credentialing verification and Enrollment aspects with payers, including initial credentialing and re-credentialing to ensure current Enrollment and timely handoff.</li><li>Participate in the development of internal credentialing &amp; Enrollment processes&middot;</li><li>Keep records of licenses, credentials, insurance contracts and other documents of groups and individual providers. &middot;</li><li>Establish a robust monitoring system to track expiring licensures, board certifications, and professional certifications. Implement proactive measures for timely renewals to prevent any lapses.</li><li>Adhere to legal requirements for information release, ensuring compliance with privacy regulations. Clearly communicate the processes for releasing information to agencies and the public, emphasizing the importance of maintaining confidentiality. &middot;</li><li>Use critical thinking skills to conduct Research, follow-up with the Insurance companies.</li><li>Establish and communicate a clear timeline for responding to inquiries from clients, health plans, and internal stakeholders. Implement effective communication channels to ensure timely and comprehensive responses.</li><li>Regularly update and maintain the CAQH profiles of assigned providers. Address any challenges in ensuring the accuracy and completeness of profiles and implement strategies for ongoing profile maintenance.</li><li>Actively participate in team meetings and process improvement initiatives to continuously improve work product quality and efficiency.</li></ul>Job Type: Full-timePay: Up to Rs150,000.00 per monthWork Location: In person

Speak Viral

The Credentialing Team Lead oversees the daily operations of the credentialing team to ensure accurate, efficient, and compliant processing of provider applications, verifications, and re-credentialing activities. This role serves as the primary liaison between the credentialing team, leadership, and other departments to maintain compliance with regulatory and payer requirements. The Team Lead is responsible for workflow coordination, staff training, quality assurance, and continuous process improvement within the credentialing function.Key Responsibilities:Leadership &amp; Team Oversight&middot; Supervise day-to-day credentialing activities to ensure timely and accurate completion of all provider files.&middot; Assign and monitor workloads to meet departmental goals and service level agreements (SLAs).&middot; Provide ongoing coaching, performance feedback, and training to credentialing specialists.&middot; Support new team members through onboarding and mentoring.Credentialing Operations&middot; Review and approve credentialing files prior to submission to payers or committees.&middot; Ensure compliance with NCQA, URAC, CMS, Joint Commission, and state/federal guidelines.&middot; Coordinate initial credentialing, re-credentialing, and primary source verification processes.&middot; Assist in the maintenance and auditing of credentialing databases and systems (e.g., CAQH, Cactus, Verity, or other platforms).&middot; Respond to escalated provider and payer inquiries in a timely and professional manner.Quality &amp; Compliance&middot; Monitor quality control measures to ensure data accuracy and regulatory compliance.&middot; Prepare reports and metrics on credentialing performance, turnaround times, and productivity.&middot; Support internal and external audits and ensure corrective actions are implemented as needed.&middot; Stay current with evolving industry regulations and best practices.Process Improvement &amp; Collaboration&middot; Identify workflow gaps and lead process improvement initiatives.&middot; Collaborate cross-functionally with provider enrollment, contracting, and human resources teams.&middot; Recommend system enhancements and contribute to policy and procedure updates.Qualifications:Education &amp; Experience&middot; Bachelor&rsquo;s degree preferred (Healthcare Administration, Business, or related field).&middot; Minimum 3&ndash;5 years of experience in provider credentialing or medical staff services.&middot; At least 1&ndash;2 years of experience in a leadership, senior, or team lead capacity preferred.Knowledge, Skills &amp; Abilities&middot; In-depth understanding of credentialing standards (NCQA, URAC, CMS, and state requirements).&middot; Strong organizational and multitasking abilities with keen attention to detail.&middot; Excellent written and verbal communication skills.&middot; Proficiency in credentialing software and Microsoft Office Suite.&middot; Ability to lead, motivate, and develop team members in a fast-paced environment.Job Type: Full-timePay: Rs70,000.00 - Rs110,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Credentialing Team Lead

RK Med Pro

Job SummaryThe Credentialing Manager will oversee offshore credentialing operations in Pakistan, ensuring U.S. provider credentialing and recredentialing activities comply with NCQA, CMS, and payer requirements, while managing team performance and audit readiness.Key Responsibilities<ul><li>Lead end-to-end provider credentialing, recredentialing, and Primary Source Verification (PSV)</li><li>Ensure compliance with NCQA standards and delegated credentialing guidelines</li><li>Manage CAQH reviews, licenses, DEA, board certifications, sanctions, and work history checks</li><li>Supervise, train, and evaluate offshore credentialing staff</li><li>Coordinate with U.S. clients, payers, and providers across time zones</li><li>Maintain audit-ready documentation and credentialing reports</li></ul>Required Qualifications<ul><li>Bachelor&rsquo;s degree or equivalent experience</li><li>4&ndash;6+ years of U.S. healthcare credentialing experience</li><li>Strong knowledge of NCQA, CMS, Medicare/Medicaid, and commercial payers</li><li>Excellent English communication and team-management skills</li></ul>Job Type: Full-timePay: Rs100,000.00 - Rs300,000.00 per monthWork Location: In person

Credentialing Manager

Ayzel Global

Company OverviewMedBillz is a US-focused medical billing and revenue cycle management company that helps healthcare providers improve compliance, reduce claim denials, and streamline payer enrollment processes.This role is being hired and managed through Ayzel Global, supporting MedBillz&rsquo;s growing US provider base.Role OverviewWe are seeking a Medical Credentialing Specialist with hands-on experience in US provider enrollment and payer credentialing. The role requires managing end-to-end credentialing workflows, ensuring compliance with payer and regulatory requirements, and working closely with billing and operations teams to prevent revenue disruptions.This is a detail-intensive role suited for professionals who understand the administrative and compliance side of US healthcare systems.Key Responsibilities<ul><li>Manage end-to-end provider credentialing and re-credentialing processes</li><li>Enroll providers with Medicare, Medicaid, and commercial payers</li><li>Complete and maintain CAQH profiles (attestation, updates, audits)</li><li>Track credentialing timelines, expirations, and renewals</li><li>Communicate with insurance payers to resolve credentialing issues</li><li>Maintain accurate credentialing records and documentation</li><li>Coordinate with billing teams to ensure claims readiness post-credentialing</li><li>Ensure compliance with US healthcare regulations and payer requirements</li><li>Support audits and credentialing-related inquiries</li></ul>Required Qualifications<ul><li>1&ndash;3+ years of experience in US medical credentialing or provider enrollment</li><li>Hands-on experience with CAQH, Medicare, Medicaid, and commercial payers</li><li>Strong understanding of US healthcare credentialing workflows</li><li>Excellent attention to detail and documentation skills</li><li>Strong written and verbal English communication</li><li>Ability to manage multiple providers and deadlines simultaneously</li></ul>Preferred Skills (Nice to Have)<ul><li>Experience working with US medical billing or RCM companies</li><li>Familiarity with EHRs, practice management systems, or credentialing software</li><li>Experience credentialing across multiple specialties</li><li>Prior experience working with US clients or offshore healthcare teams</li></ul>What We Offer<ul><li>Full-time, stable role within a growing US healthcare services company</li><li>Competitive salary (based on experience)</li><li>Exposure to US healthcare compliance and payer systems</li><li>Structured processes and long-term growth opportunities</li><li>Supportive, systems-driven work environment</li></ul>Work Type<ul><li>Work Type: Full-time</li><li>Location: On-site / Remote (as per company policy)</li><li>Client: US Healthcare Company (MedBillz)</li></ul>Job Type: Full-timePay: Rs85,000.00 - Rs125,000.00 per monthWork Location: In person

Medical Credentialing Specialist

The Credentialing Executive is responsible for managing the provider enrollment and credentialing process with insurance companies, hospitals, and other healthcare organizations. This role ensures all providers are properly credentialed and enrolled to receive timely reimbursement for medical services, maintaining compliance with payer and regulatory requirements.Key Responsibilities:&middot; Prepare, review, and submit credentialing and re-credentialing applications for healthcare providers with commercial and government insurance payers (e.g., Medicare, Medicaid, BCBS, Aetna, UnitedHealthcare, Cigna, etc.).&middot; Maintain up-to-date records of providers in credentialing databases and online systems.&middot; Track the status of credentialing and enrollment applications, follow up with payers, and resolve any discrepancies or issues.&middot; Verify provider credentials, including licenses, board certifications, DEA, malpractice insurance, and other necessary documents.&middot; Coordinate with internal billing teams to ensure providers are properly linked and active with payers before billing.&middot; Update and maintain CAQH profiles, NPI registrations, and PECOS enrollments.&middot; Manage expirables (licenses, insurance, certifications) and notify providers of renewals.&middot; Ensure compliance with federal, state, and payer-specific regulations.&middot; Generate and maintain credentialing reports and dashboards.&middot; Communicate professionally with providers, practice managers, and insurance representatives.Required Qualifications:&middot; Bachelor&rsquo;s degree in Healthcare Administration, Business, or a related field (or equivalent work experience).&middot; 1&ndash;3 years of experience in medical credentialing, provider enrollment, or medical billing.&middot; Knowledge of CAQH, NPPES, PECOS, and payer portals.&middot; Strong understanding of commercial and government payer processes.&middot; Excellent communication and organizational skills.&middot; Proficiency in MS Office (Excel, Word, Outlook) and credentialing software.&middot; Ability to handle multiple tasks, prioritize, and meet deadlines.Preferred Qualifications:&middot; Experience with US-based healthcare systems or RCM/BPO companies.&middot; Certification in credentialing (e.g., CPCS, CPMSM) is a plus.&middot; Knowledge of medical billing and compliance regulations (HIPAA, CMS).Key Competencies:&middot; Attention to detail and accuracy&middot; Strong problem-solving and analytical skills&middot; Professional communication and interpersonal skills&middot; Time management and ability to work independently&middot; Team collaborationJob Type: Full-timePay: Rs30,000.00 - Rs50,000.00 per monthApplication Question(s):<ul><li>Will you be able to work night shift(7pm to 4am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Credentialing Executive

PCS Pakistan

About Practice Care Solutions (PCS)Practice Care Solutions (PCS) is a healthcare services company specializing in end-to-end Revenue Cycle Management (RCM) and practice support solutions for US-based healthcare providers.PCS helps physician practices, clinics, and healthcare organizations optimize revenue, reduce administrative burden, and improve operational efficiency through services such as:<ul><li>Medical billing and coding</li><li>Provider credentialing and enrollment</li><li>Accounts receivable and denial management</li><li>Eligibility and benefits verification</li><li>Compliance-driven RCM solutions</li></ul>By combining industry expertise, technology, and dedicated teams, PCS enables healthcare providers to focus on patient care while we manage their revenue operations.Job SummaryPractice Care Solutions (PCS) Pakistan is seeking a highly motivated and experienced Business Development Professional to expand our US healthcare client base. The ideal candidate will have strong hands-on experience in Revenue Cycle Management (RCM), including medical billing and provider credentialing, as well as a proven background in business development and sales for US healthcare outsourcing services.Candidates with direct business development experience selling medical billing and credentialing services to US-based healthcare providers will be strongly preferred.Key ResponsibilitiesUS Market Business Development<ul><li>Identify, target, and acquire US-based healthcare clients, including physician practices, clinics, hospitals, MSOs, and medical billing companies</li><li>Develop new business opportunities through cold calling, email campaigns, LinkedIn outreach, networking, and referrals</li><li>Conduct virtual meetings, presentations, and service demos with US healthcare decision-makers</li><li>Build and manage a strong sales pipeline focused on RCM, medical billing, and credentialing services</li></ul>Sales &amp; Client Acquisition<ul><li>Negotiate pricing, contracts, and service agreements with US healthcare providers. Sell end-to-end Revenue Cycle Management services, including:</li><li>Medical billing &amp; coding</li><li>Accounts receivable (AR) follow-ups</li><li>Provider credentialing &amp; enrollment</li><li>Eligibility &amp; benefits verification</li><li>Payment posting and denial management</li><li>Understand client pain points related to billing inefficiencies, credentialing delays, revenue leakage, and compliance</li><li>Propose customized RCM and billing solutions based on practice size, specialty, and payer mix</li></ul>Relationship &amp; Account Management<ul><li>Build and maintain long-term relationships with US clients and key stakeholders</li><li>Act as the primary point of contact during onboarding and early-stage client engagement</li><li>Coordinate with internal operations, billing, and credentialing teams to ensure smooth client transition</li><li>Ensure high levels of client satisfaction and retention</li></ul>Market Intelligence &amp; Strategy<ul><li>Stay updated on US healthcare regulations, CMS guidelines, payer policies, and credentialing requirements</li><li>Monitor industry trends related to medical billing, credentialing, and RCM outsourcing</li><li>Analyze competitors and market demand to refine business development strategies</li><li>Provide regular feedback and insights to management on market opportunities and challenges</li></ul>Education<ul><li>Bachelor&rsquo;s degree in Business, Marketing, Healthcare Administration, or a related field</li><li>MBA or relevant healthcare/RCM certifications will be a plus</li></ul>Experience<ul><li>3+ years of Business Development or Sales experience in US healthcare outsourcing</li><li>Demonstrated experience in Revenue Cycle Management, including:</li><li>Medical billing services</li><li>Provider credentialing and enrollment</li><li>Proven track record of closing US-based healthcare clients</li><li>Prior experience selling medical billing and credentialing services will be highly preferred</li></ul>Required Skills &amp; Competencies<ul><li>Strong understanding of US Revenue Cycle workflows, medical billing, coding, insurance processes, and credentialing</li><li>Excellent English communication, presentation, and negotiation skills</li><li>Experience working in US time zones</li><li>Expertise in lead generation, pipeline management, and closing deals</li><li>Proficiency in CRM tools, MS Office, and LinkedIn Sales Navigator</li><li>Ability to work independently in a performance-driven environment</li></ul>What We Offer<ul><li>Competitive salary with benefits</li><li>Growth opportunities in a fast-growing US healthcare outsourcing environment</li><li>Exposure to international clients and the US healthcare ecosystem</li><li>A professional, collaborative, and performance-driven work culture</li></ul>Job Type: Full-timePay: Rs100,000.00 - Rs120,000.00 per monthWork Location: In person

Business Development Executive

Explore 220+ Credentialing analyst in Pakistan this January. Find roles across top companies and apply now to boost your career.

220 credentialing analyst jobs IN Pakistan

Credentialing Analyst

Credentialing Analyst

Credentialing Team Lead

Credentialing Manager

Medical Credentialing Specialist

Credentialing Executive

Business Development Executive