bd specialist (emr/ healthcare-saas) Jobs in Lahore

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credentialing specialist

Physicians Revenue Group

<ul><li>erform end-to-end credentialing and re-credentialing for healthcare providers with US insurance payers</li><li>Handle payer enrollments (Medicare, Medicaid, and commercial plans) to ensure billing readiness</li><li>Maintain and regularly update CAQH profiles, ensuring accuracy for claim processing</li><li>Verify provider eligibility before onboarding to avoid claim rejections/denials</li><li>Coordinate closely with medical billing teams to resolve credentialing-related claim issues</li><li>Monitor and follow up on pending applications to prevent revenue delays</li><li>Ensure all provider data (NPI, taxonomy, licenses, malpractice insurance) is accurate and up to date</li><li>Work on ERA/EFT enrollments to streamline payment processes</li><li>Support denial management by identifying credentialing gaps impacting reimbursements</li><li>Maintain compliance with payer-specific guidelines and regulatory requirements</li><li>Prepare credentialing status reports, turnaround time tracking, and aging reports</li></ul>Job Type: Full-timeWork Location: In person

Credentialing Specialist

Prima Systems

We are seeking a detail-oriented and experienced Credentialing and Enrollment Associate to join our medical billing team. The ideal candidate will have a strong background in healthcare credentialing and enrollment processes, particularly within the US healthcare system. This role will involve ensuring that healthcare providers are properly credentialed with insurance networks and government programs, facilitating enrollment, and maintaining accurate records.Responsibilities:<ul><li>Manage the credentialing and enrollment process for healthcare providers with insurance networks, Medicare, Medicaid, and other relevant programs.</li><li>Prepare and submit credentialing applications, re-credentialing, and revalidation documents accurately and timely.</li><li>Ensure compliance with all credentialing requirements, regulations, and standards set by accrediting bodies and government agencies.</li><li>Communicate with insurance companies, providers, and internal stakeholders to resolve credentialing issues and inquiries.</li><li>Maintain up-to-date knowledge of current healthcare regulations, policies, and procedures related to credentialing and enrollment.</li><li>Coordinate with internal departments to gather necessary documents and information for credentialing applications.</li><li>Monitor the status of applications, track expirations, and follow up on pending items to ensure timely completion.</li><li>Maintain accurate and organized credentialing and enrollment records, both electronic and paper-based.</li><li>Assist in audits and reviews related to credentialing and enrollment processes.</li></ul>Requirements:<ul><li>Minimum of 2-3 years of experience in healthcare credentialing and enrollment, preferably in a medical billing setting.</li><li>In-depth knowledge of credentialing processes for insurance networks, Medicare, Medicaid, and other payers.</li><li>Familiarity with CAQH, NPI, UPIN, and other relevant healthcare databases and identifiers.</li><li>Strong understanding of healthcare regulations, compliance standards, and HIPAA guidelines.</li><li>Excellent English communication skills, both verbal and written, with the ability to interact professionally with providers and insurance representatives.</li><li>Exceptional attention to detail, accuracy, and organizational skills.</li><li>Proficiency in using MS Office applications and credentialing software.</li><li>Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.</li></ul>Job Type: Full-timePay: Rs100,000.00 - Rs130,000.00 per monthApplication Question(s):<ul><li>Are you available for night shift</li></ul>Experience:<ul><li>Credentialing in Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Preferred)</li></ul>Work Location: In person

Top Line Resource Group (TLRG)

Location: DHA phase 8, Lahore (Onsite) Work Schedule: 05PM &ndash; 02AM Pakistan Time Employment Type: Full-time (Night Shift)Topline Resource Group (TLRG) is looking for a knowledgeable Credentialing and Enrollment Specialist to support the provider onboarding process and maintain payer credentialing records. This role focuses on ensuring healthcare providers are successfully enrolled with insurance carriers and that all credentialing documentation remains current and compliant with industry standards.The successful candidate will play an important role in coordinating credentialing activities, maintaining provider records, and communicating with payers to ensure smooth enrollment and approval processes.Core Responsibilities<ul><li>Handle the enrollment process for healthcare providers with insurance payers including Commercial plans, Medicare, Medicaid, and other specialty networks.</li><li>Maintain comprehensive credentialing documentation, ensuring records such as licenses, certifications, DEA registration, NPI information, and CAQH profiles remain accurate and updated.</li><li>Prepare and submit credentialing applications for new provider enrollment, renewals, and information updates with insurance carriers.</li><li>Monitor the progress of submitted applications and follow up with payers to facilitate timely processing and approvals.</li><li>Ensure all credentialing procedures comply with industry standards and payer policies, including NCQA and URAC requirements.</li><li>Review and validate provider documentation to confirm all credentialing criteria and regulatory standards are met.</li><li>Collaborate with internal departments such as Human Resources, Compliance, and Billing to support provider onboarding and credentialing updates.</li><li>Address credentialing discrepancies, assist with payer inquiries, and resolve enrollment-related issues when they arise.</li><li>Maintain organized records and generate reports related to provider enrollment and credentialing activities.</li></ul>Required Experience &amp; Qualifications<ul><li>Minimum 2&ndash;3 years of professional experience in provider enrollment and credentialing within the healthcare industry.</li><li>Strong understanding of U.S. healthcare insurance systems and credentialing workflows.</li><li>Working knowledge of credentialing standards including NCQA, URAC, and payer regulations.</li><li>Experience using credentialing platforms and EHR/Practice Management systems.</li><li>Strong organizational skills with the ability to manage multiple assignments efficiently.</li><li>Excellent written and verbal communication abilities.</li><li>High level of accuracy and attention to detail.</li></ul>Preferred Qualifications<ul><li>Experience handling provider enrollment across multiple U.S. states.</li><li>Ability to work independently in a fast-paced, high-volume environment while meeting deadlines.</li><li>Background in Revenue Cycle Management (RCM), medical billing, or healthcare administration is a plus.</li></ul>Pay: Rs80,000.00 - Rs110,000.00 per monthExperience:<ul><li>enrollment and credentialing: 2 years (Preferred)</li></ul>Work Location: In person

Credentialing and Enrollment Executive - (US Healthcare)

We are seeking a detail-oriented and experienced Credentialing and Enrollment Associate to join our medical billing team. The ideal candidate will have a strong background in healthcare credentialing and enrollment processes, particularly within the US healthcare system. This role will involve ensuring that healthcare providers are properly credentialed with insurance networks and government programs, facilitating enrollment, and maintaining accurate records.Responsibilities:<ul><li>Manage the credentialing and enrollment process for healthcare providers with insurance networks, Medicare, Medicaid, and other relevant programs.</li><li>Prepare and submit credentialing applications, re-credentialing, and revalidation documents accurately and timely.</li><li>Ensure compliance with all credentialing requirements, regulations, and standards set by accrediting bodies and government agencies.</li><li>Communicate with insurance companies, providers, and internal stakeholders to resolve credentialing issues and inquiries.</li><li>Maintain up-to-date knowledge of current healthcare regulations, policies, and procedures related to credentialing and enrollment.</li><li>Coordinate with internal departments to gather necessary documents and information for credentialing applications.</li><li>Monitor the status of applications, track expirations, and follow up on pending items to ensure timely completion.</li><li>Maintain accurate and organized credentialing and enrollment records, both electronic and paper-based.</li><li>Assist in audits and reviews related to credentialing and enrollment processes.</li></ul>Requirements:<ul><li>Graduation is mandatory.</li><li>Minimum of 06 months of experience in healthcare credentialing and enrollment, preferably in a medical billing setting.</li><li>In-depth knowledge of credentialing processes for insurance networks, Medicare, Medicaid, and other payers.</li><li>Familiarity with CAQH, NPI, UPIN, and other relevant healthcare databases and identifiers.</li><li>Strong understanding of healthcare regulations, compliance standards, and HIPAA guidelines.</li><li>Excellent English communication skills, both verbal and written, with the ability to interact professionally with providers and insurance representatives.</li><li>Exceptional attention to detail, accuracy, and organizational skills.</li><li>Proficiency in using MS Office applications and credentialing software.</li><li>Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.</li></ul>Job Type: Full-timePay: Rs60,000.00 - Rs75,000.00 per monthApplication Question(s):<ul><li>Are you available for night shift</li></ul>Experience:<ul><li>Credentialing in Medical Billing: 1 year (Preferred)</li></ul>Language:<ul><li>English (Preferred)</li></ul>Work Location: In person

Credentialing Associate

Physician Cure

Credentialing Executive with the experience of 1-2 years is required in Tritech services Medical billing company located at 20-L Ex air avenue DHA phase 8 Lahore. Whatsapp 0326-4565645. Shift timings 7:00pm to 04:00am.Job Type: Full-timePay: Rs60,000.00 - Rs70,000.00 per monthWork Location: In person

Credentialing Executive for Medical Billing company

Diglip

We are seeking a highly experienced Laboratory Billing Specialist / RCM Manager to oversee and optimize all aspects of our diagnostic laboratory billing operations. This role will act as the internal billing authority, working closely with our third-party billing company to ensure clean claim submission, minimize denials, and maximize reimbursement.The ideal candidate must have deep expertise in clinical laboratory billing, coding, payer guidelines, and denial management, and should be capable of identifying gaps, resolving issues, and implementing process improvements.Key Responsibilities<ul><li>Oversee and audit the performance of the external billing company</li><li>Review and ensure clean claim submission (first-pass resolution)</li><li>Analyze and resolve denials (CO-45, CO-97, CO-16, PR-96, etc.)</li><li>Identify root causes of denials and implement corrective workflows</li><li>Monitor AR (Accounts Receivable) and aging reports</li><li>Ensure proper usage of CPT codes, ICD-10 codes, modifiers (e.g., 59, 91, 25)</li><li>Validate medical necessity compliance (LCD/NCD guidelines)</li><li>Manage payer-specific requirements (Medicare, Medicaid, BCBS, Aetna, UHC, etc.)</li><li>Work on eligibility verification and benefits investigation</li><li>Review EOBs/ERAs and payment posting accuracy</li><li>Ensure proper credentialing and enrollment (NPI, CLIA, PECOS, CAQH)</li><li>Maintain compliance with HIPAA and CMS billing regulations</li><li>Coordinate with lab operations for proper test coding &amp; panel setup</li><li>Optimize workflows for high-volume tests (CBC, CMP, Ferritin, Toxicology, etc.)</li><li>Track rejection trends and clearinghouse errors</li><li>Generate weekly/monthly billing performance reports</li><li>Implement strategies to reduce write-offs and maximize collections</li></ul>Required Skills &amp; ExpertiseCore Billing Knowledge<ul><li>Strong understanding of Laboratory Billing (Clinical &amp; Toxicology preferred)</li><li>Expertise in:</li><li>CPT / HCPCS coding</li><li>ICD-10 diagnosis coding</li><li>Modifiers usage</li><li>Medical necessity rules</li><li>Hands-on experience with:</li><li>Denial Management &amp; Appeals</li><li>AR Follow-ups</li><li>Insurance Verification</li><li>Charge Entry &amp; Payment Posting</li></ul>Technical &amp; System Skills<ul><li>Experience with LIS (Laboratory Information Systems) and billing software</li><li>Familiarity with Clearinghouses (Office Ally, Change Healthcare, etc.)</li><li>Knowledge of EDI transactions (837, 835, 270/271)</li><li>Ability to audit data between LIS and Billing Systems</li><li>Strong Excel / Google Sheets skills for reporting &amp; analytics</li></ul>Payer &amp; Compliance Knowledge<ul><li>Experience handling:</li><li>Medicare / Medicaid billing</li><li>Commercial insurance (BCBS, Aetna, UHC, Cigna, etc.)</li><li>Understanding of:</li><li>LCD/NCD policies</li><li>Frequency limitations</li><li>Bundling &amp; unbundling rules</li><li>Familiarity with CLIA regulations for lab billing</li></ul>Credentialing &amp; Enrollment<ul><li>Experience with:</li><li>Provider Enrollment (PECOS, CAQH)</li><li>NPI registration and maintenance</li><li>CLIA certification handling</li><li>Ability to ensure lab is properly enrolled with all payers</li></ul>Preferred Qualifications<ul><li>Experience working with high-complexity labs or toxicology labs</li><li>Prior experience managing or auditing outsourced billing teams</li><li>Knowledge of HL7 integrations and lab-machine workflows</li><li>Certification such as:</li><li>CPB (Certified Professional Biller)</li><li>CPMA / CPC (AAPC)</li></ul>Key Performance Indicators (KPIs)<ul><li>Reduction in denial rate (%)</li><li>Increase in clean claim rate</li><li>Improvement in AR days</li><li>Recovery of underpaid / denied claims</li><li>Accuracy in coding and billing compliance</li></ul>Note: Candidates without hands-on lab billing experience will not be considered.Job Type: Full-timePay: Rs150,000.00 - Rs200,000.00 per monthApplication Question(s):<ul><li>How many years of US laboratory billing experience do you have?</li><li>Have you worked with denial codes like CO-45, CO-97, CO-16, PR-96?</li><li>Are you comfortable working onsite and night shifts (US hours)?</li></ul>Work Location: In person

Laboratory Billing Specialist / Revenue Cycle Manager (RCM)

Virtuality Developers

<div>
 
 Virtuality Developers, provides reliable healthcare support services, focusing on medical billing and credentialing services for healthcare providers in the United States. With expertise in Revenue Cycle Management (RCM), our experienced team ensures accuracy, compliance, and efficiency in managing the financial operations of doctors, nurse practitioners, and therapists. By streamlining administrative processes, we help healthcare providers reduce claim denials, accelerate reimbursements, and maintain cash flow consistency for better patient care. We are dedicated to fostering a supportive work environment, promoting skill development, and encouraging professional growth to deliver high-quality services to our clients based on professionalism, transparency, and innovation.
 
 
 
 
 
 
 Role Description
 
 
 
 This is a full-time, on-site position located in DHA PHASE 8 Lahore for a Sales Executive. The Sales Executive will focus on identifying and developing leads, managing client relationships, and achieving sales targets. Responsibilities include engaging in direct sales activities, conducting market research to identify potential clients, reaching out to prospects, delivering presentations, and ensuring client satisfaction. The role also involves working passionately to grow revenue, contributing to business growth, and collaborating with the team to design tailored solutions based on client needs.
 
 
 
 
 
 
 Qualifications
 
 
 <ul>
 <li>
 Sales and Business Development: Ability in lead generation, direct sales, and achieving or exceeding sales targets.
 </li>
 <li>
 Communication and Interpersonal Skills: Strong verbal and written communication, active listening skills, and the ability to build lasting client relationships.
 </li>
 <li>
 Customer Relationship Management: Experience in managing client accounts, resolving issues, and maintaining client satisfaction.
 </li>
 <li>
 Strategic Thinking and Market Analysis: Capability to conduct market research, assess client needs, and align solutions with business goals.
 </li>
 <li>
 Team Collaboration: Demonstrated ability to work effectively within a team and contribute to collective goals.
 </li>
 <li>
 Self-motivation, results-driven attitude, and a desire for professional growth.
 </li>
 </ul>
 
 
 
 
 
 Shift
 
 8PM till 5AM
 
 
 
 Location
 
 Phase 8, DHA Lahore
 
 
 
 Salary
 
 : Salary will be decided at the time of interview
 
</div>

Sales Executive

Explore 155+ Credentialing specialist in Lahore this April. Find roles across top companies and apply now to boost your career.

155 credentialing specialist jobs In Lahore

Credentialing Specialist

Credentialing Specialist

Credentialing and Enrollment Executive - (US Healthcare)

Credentialing Associate

Credentialing Executive for Medical Billing company

Laboratory Billing Specialist / Revenue Cycle Manager (RCM)

Sales Executive