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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

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

Jawa Health Care

Job Title: Credentialing Expert Department: Credentialing / RCM Industry: Healthcare / DME Experience: 1&ndash;3 years (Fresh + Experienced can apply)Job SummaryWe are looking for a detail-oriented Credentialing Expert to manage provider enrollment, re-credentialing, and compliance with insurance networks. The ideal candidate will ensure timely onboarding of providers and maintain accurate credentialing records.Key Responsibilities<ul><li>Handle provider enrollment with Medicare, Medicaid, and commercial payers</li><li>Manage CAQH profiles (creation, updating, attestation)</li><li>Submit and track credentialing and re-credentialing applications</li><li>Follow up with insurance companies for application status</li><li>Maintain provider documentation (licenses, NPI, DEA, malpractice insurance)</li><li>Ensure compliance with payer requirements and deadlines</li><li>Resolve credentialing-related issues and delays</li><li>Maintain accurate records in credentialing systems</li></ul>Requirements<ul><li>Bachelor&rsquo;s degree (preferred)</li><li>Knowledge of US healthcare credentialing process</li><li>Familiarity with CAQH, PECOS, NPPES</li><li>Strong communication and follow-up skills</li><li>Good command of MS Excel and documentation</li></ul><ul><li>Shift: Night shift (US timing)</li><li>6pm to 3am</li><li>Monday to Friday</li><li>Saturday Sunday off</li><li>Location: On-site</li><li>Salary: Market competitive</li><li>Perks: Growth, training,</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

Credentialing Expert

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

Job Summary:The Credentialing Executive is responsible for managing the end-to-end provider credentialing and re-credentialing process with insurance payers, ensuring compliance with regulatory standards and maintaining accurate provider records.Key Responsibilities:<ul><li>Handle provider enrollment and credentialing with Medicare, Medicaid, and commercial insurance payers</li><li>Prepare and submit credentialing applications (initial, revalidation, and re-credentialing)</li><li>Maintain and update CAQH profiles and ensure data accuracy</li><li>Track application status and follow up with payers for approvals</li><li>Maintain a database of provider credentials including licenses, certifications, and malpractice insurance</li><li>Ensure compliance with NCQA, CMS, and payer guidelines</li><li>Coordinate with internal departments (billing, compliance, operations)</li><li>Manage re-credentialing timelines and ensure timely renewals</li><li>Resolve credentialing-related issues and denials</li><li>Maintain proper documentation and audit-ready files</li></ul>Required Qualifications:<ul><li>Bachelor&rsquo;s degree (Healthcare Administration preferred)</li><li>1&ndash;3 years of experience in medical credentialing/enrollment (DME experience preferred)</li><li>Strong knowledge of Medicare, Medicaid, and commercial payer processes</li><li>Experience with CAQH, PECOS, NPPES systems</li><li>Good communication and follow-up skills</li></ul>Skills Required:<ul><li>Attention to detail</li><li>Strong organizational skills</li><li>Time management and deadline handling</li><li>Knowledge of healthcare compliance regulations</li><li>Proficiency in MS Office / Excel</li></ul>Preferred Qualifications:<ul><li>Experience in DME (Durable Medical Equipment) credentialing</li><li>Familiarity with US healthcare system</li><li>Prior experience working in night shift (for US-based processes)</li></ul>KPIs / Performance Metrics:<ul><li>Application turnaround time</li><li>Approval rate from payers</li><li>Accuracy of submitted applications</li><li>Re-credentialing completion rate</li><li>Compliance audit results</li></ul>Work Timings (Optional &ndash; Customize):<ul><li>Night Shift (US Time Zone)</li><li>Example: 6:00 PM &ndash; 3:00 AM (PKT)</li></ul>Job Type: Full-timePay: Rs40,000.00 - Rs50,000.00 per monthWork Location: In person

Credentialing Executive Medical Billing

Interact Global

Credentialing &amp; VOB Executive (Medical Billing &ndash; Night Shift)Salary: PKR 60,000 &ndash; 90,000 (Based on Experience) Job Type: Full-time Experience Required: Minimum 1 Year Location: Wapda Town Phase 1, Lahore Shift: Night Shift (5:30 PM &ndash; 2:30 AM) Schedule: Monday &ndash; Friday (Weekends Off)Job OverviewWe are looking for a detail-oriented Credentialing &amp; VOB Executive with at least 1 year of hands-on experience in US medical billing processes. The ideal candidate will be responsible for provider credentialing, enrollment, and insurance verification while ensuring accuracy and timely processing.Key Responsibilities<ul><li>Manage provider credentialing and enrollment with insurance companies</li><li>Submit and follow up on applications (CAQH, Medicare, Medicaid, commercial payers)</li><li>Perform Verification of Benefits (VOB) including eligibility, co-pays, deductibles, and coverage details</li><li>Communicate with insurance companies via calls and online portals</li><li>Maintain and update records in billing software / CRM systems</li><li>Track credentialing status and resolve delays or rejections</li><li>Ensure compliance with payer requirements and timelines</li></ul>Requirements<ul><li>Minimum 1 year of experience in Credentialing, Enrollment, or VOB</li><li>Basic understanding of US healthcare and insurance processes</li><li>Familiarity with insurance portals (e.g., Availity, Navinet, etc.)</li><li>Good English communication skills (for calls &amp; emails)</li><li>Strong attention to detail and organizational skills</li><li>Ability to work in night shift (US hours)</li></ul>Compensation &amp; Benefits<ul><li>Competitive salary (PKR 60K &ndash; 90K)</li><li>Performance-based increments</li><li>20 (Sick &amp; Casual) Paid annual leaves + 3 paternity &amp; 3 bereavement leaves</li><li>Paid public holidays &amp; US Federal Holiday</li><li>Transport facility for female employees (50% covered)</li><li>Fuel Allowance</li><li>OPD &amp; IPD Allowance</li><li>Career growth in the medical billing domain</li></ul>Who Should Apply?✔ Candidates with at least 1 year relevant experience only ✔ Individuals currently working in medical billing (Credentialing/VOB) ✔ Candidates looking to grow in the US healthcare industryHow to ApplyApply now with your updated CV. Only shortlisted candidates will be contacted.Pay: Rs60,000.00 - Rs90,000.00 per monthWork Location: In person

Credentialing & VOB Executive (Medical Billing – Night Shift)

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

Explore 135+ Credentialing specialist in Lahore this May. Find roles across top companies and apply now to boost your career.

135 credentialing specialist jobs In Lahore

Credentialing Specialist

Credentialing Specialist

Credentialing Expert

Credentialing Associate

Credentialing Executive Medical Billing

Credentialing & VOB Executive (Medical Billing – Night Shift)

Credentialing Executive for Medical Billing company