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credentialing specialist

EdSavvy Solutions

Job Title: Credentialing SpecialistCompany: Edsavvy Solutions Location: Lahore (Near UCP) Shift Timing: 5:00 PM &ndash; 2:00 AM Job Type: Full-timeAbout Us: Edsavvy Solutions is a Lahore-based medical billing company providing services to clients in the United States. We are seeking a detail-oriented and motivated Credentialing Specialist to join our growing team.Job Responsibilities:<ul><li>Manage provider credentialing and re-credentialing processes</li><li>Prepare and submit credentialing applications to insurance panels</li><li>Maintain accurate provider records and documentation</li><li>Follow up with insurance companies regarding application status</li><li>Ensure compliance with industry standards and client requirements</li></ul>Key Requirements:<ul><li>6 months to 2 years of experience in credentialing</li><li>Experience in dental credentialing can be considered</li><li>Strong attention to detail and organizational skills</li><li>Willingness to work in the night shift (5:00 PM &ndash; 2:00 AM)</li></ul>What We Offer:<ul><li>Professional work environment</li><li>Growth and career development opportunities</li><li>Exposure to international clients</li></ul>How to Apply: Interested candidates are encouraged to send their resumes to: Email: hr@edsavvysolutions.comPay: Rs50,000.00 - Rs100,000.00 per monthWork Location: In person

Credentialing Specialist

Tigon Tech Solutions

Credentialing Specialist &ndash; Healthcare (On-Site | Lahore)We are a growing medical billing company based in Lahore, providing services to healthcare practices across the United States. We are currently hiring a Credentialing Specialist to join our team.Key Responsibilities:<ul><li>Handle provider credentialing and re-credentialing with insurance payers</li><li>Manage CAQH profiles and ensure information is accurate and up to date</li><li>Submit and track applications with various insurance companies</li><li>Follow up with payers to ensure timely approvals</li><li>Maintain documentation and provider records</li><li>Work across multiple specialties and US states</li></ul>Requirements:<ul><li>Minimum 1 year of hands-on experience in medical credentialing</li><li>Strong understanding of the credentialing process and payer requirements</li><li>Experience working with multiple specialties and US states</li><li>Good English communication skills (written and verbal)</li><li>Ability to manage multiple tasks and meet deadlines</li></ul>Job Details:<ul><li>Location: On-site (Lahore)</li><li>Shift: Night shift (aligned with US hours)</li><li>Type: Full-time</li></ul>We are looking for someone reliable, detail-oriented, and ready to grow with a fast-paced team.If you meet the above criteria, we encourage you to apply.Job Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthWork Location: In person

HA-Technologies

WE ARE HIRINGCredentialing Specialist on urgent basis.━━━━━━━━━━━━━Company: MedxCode LLC.Location: Blue Area, IslamabadExperience: minimum 2 YearsKey Responsibilities:* Submitting credentialing applications for healthcare providers.* Follow-up with insurance companies regarding application status.* Managing and updating CAQH profiles.* Performing CAQH Attestation.* Ensuring all provider documents are complete and accurate.Perks &amp; Benefits:* Competitive salary package.* Friendly and professional work environment.* Learning and career growth opportunities.* Paid leaves as per company policy.Application Question(s):<ul><li>How many years of experience do you have in medical credentialing?</li><li>Do you have hands-on experience with CAQH profile management and attestation? (Yes/No)</li><li>Have you previously worked with US healthcare credentialing processes? (Yes/No)</li><li>Can you handle credentialing applications submission and follow-ups with insurance companies independently? (Yes/No)</li><li>Which credentialing software/tools have you used?</li><li>Are you familiar with insurance panels and provider enrollment processes? (Yes/No)</li><li>How soon can you join?</li><li>What is your expected salary?</li></ul>Work Location: In person

Revmed

Job Summary:We are seeking a detail-oriented and experienced Medical Credentialing &amp; Enrollment Specialist to manage provider credentialing, re-credentialing, and payer enrollment processes. The ideal candidate will ensure compliance with insurance and regulatory requirements while maintaining accurate provider records and timely submissions.Key Responsibilities:<ul><li>Manage end-to-end provider credentialing and enrollment with insurance payers (Medicare, Medicaid, Commercial Plans).</li><li>Prepare and submit initial credentialing and re-credentialing applications.</li><li>Maintain and update provider information in CAQH (Council for Affordable Quality Healthcare).</li><li>Track application status and follow up with payers to ensure timely approvals.</li><li>Handle provider enrollment, revalidation, and demographic updates.</li><li>Maintain accurate records of provider credentials, licenses, certifications, and expirations.</li><li>Coordinate with internal departments (billing, HR, compliance) for required documentation.</li><li>Resolve credentialing-related issues and payer denials.</li><li>Ensure compliance with healthcare regulations and payer requirements.</li><li>Maintain credentialing database and prepare reports as required.</li></ul>Requirements:<ul><li>Bachelor&rsquo;s degree or relevant experience in Healthcare Administration or related field.</li><li>1&ndash;3+ years of experience in US medical credentialing and enrollment.</li><li>Hands-on experience with CAQH, PECOS, NPPES, and payer portals.</li><li>Strong knowledge of Medicare, Medicaid, and commercial insurance processes.</li><li>Excellent communication and follow-up skills.</li><li>Strong attention to detail and organizational skills.</li><li>Ability to handle multiple providers and deadlines simultaneously.</li></ul>Preferred Skills:<ul><li>Experience in RCM (Revenue Cycle Management) environment.</li><li>Familiarity with credentialing software/tools.</li><li>Knowledge of compliance and healthcare regulations.</li><li>Ability to work independently and in a team environment.</li></ul>Benefits (Customize as per your company):<ul><li>Competitive Salary Package</li><li>Post-Probation &amp; Annual Increments</li><li>Family Health Insurance</li><li>Paid Leaves &amp; Leave Encashment</li><li>Performance &amp; Retention Bonuses</li><li>Meal Allowance</li><li>Pick &amp; Drop (for female staff)</li></ul>Job Type: Full-timeWork Location: In person

Medical Credentialing & Enrollment Specialists

Meds IT Nexus

Job descriptionMeds Nexus is looking for candidates on the night shift with experience as Team Lead Credentialing &amp; EDI. The candidate should be enthusiastic and must have a proven work experience in performing all New Client Account Setups, Research and Development activities, ensuring that the credentialing requirements for government and commercial payers are met, Submit and follow-up on submitted credentialing requests to all contracted commercial payers and government agencies, maintain the close working relations experience will be preferred along with Basic IT skills (databases, MS Office, etc.)Job Responsibilities:3 to 5 years of experience in credentialing departmentAt least 1 year of experience in a Supervisory RoleExperience in credentialing different specialties with major regular and private payers state-wiseReview the approval and termination of professional provider contracts as they relate to the credentialing processEnsure accurate and timely information for re-credentialing, data analysis, and directory generation, as well as recommending changes to the credentialing criteria and processesMaintain all credentialing and re-credentialing policies and processes to ensure that they comply with all applicable regulationsDevelop and implement departmental goals and objectives with input from staff membersDevelop and implement departmental policies and procedures that guide and support the provision of servicesInteract with all customers to ensure prompt and accurate communication as needed to provide the service expected and to meet the goals of the service.Job Types: Contract, Full-timeAbility to commute/relocate:<ul><li>Rawalpindi: Reliably commute or planning to relocate before starting work (Required)</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Experience:<ul><li>Credentialing &amp; Enrollment + EDI: 5+ years (Preferred)</li></ul>Language:<ul><li>Fluent English (Preferred)</li></ul>Job Type: Full-timeWork Location: In person

Credentialing Team Lead

VMBS

Qulifications:Night Shift Only male candidates will be hiredMust have BA or BBA/MBA degreeOr 14 years of education from reputable universityWilling to work in night shift 7PM to 4AMExcelent verbal and written English Skills NeededFreshers can apply (males only)Vigilant Medical Billing Service (Old Airport road, Rawalpindi) is looking for candidates with these Key Responsibilities: Learn and understand the enrollment and credentialing process, including basics, Customer relations and follow-up. Participate in daily activities with team. Manage inbound and outbound calls with insurance companies. Also Support the company in strengthen and grow relationships with clients by communicating with customers regarding past-due application and filing new applications. Exercise integrity and confidentiality in financial reporting, and comply with national and local financial requirements.Job Types: Full-time, Internship, Fresher Contract length: 12 monthsPay: Rs35,000.00 - Rs45,000.00 per monthApplication Question(s):<ul><li>Rate your verbal and written English communication?</li></ul>Education:<ul><li>Bachelor's (Preferred)</li></ul>Language:<ul><li>English (Required)</li></ul>Location:<ul><li>Rawalpindi (Required)</li></ul>Work Location: In person

Management Trainee Officer (night shift)

Position Title: Auditor Specialist &ndash; Revenue Cycle Management (RCM)Department: Medical Billing &amp; CredentialingLocation: RawalpindiCompany: Meds NexusJob Overview The Auditor Specialist for Revenue Cycle Management (RCM) is responsible for overseeing the auditing processes within the medical billing and credentialing functions. The role involves conducting detailed audits, ensuring compliance with regulations, identifying areas for improvement, and implementing corrective actions to optimize revenue cycle performance. The auditor will mentor team members, provide consulting services, manage risks, and collaborate closely with operations and billing teams to enhance the RCM process.Key Responsibilities1. Audit Planning and Execution:- Develop and implement comprehensive audit plans for medical billing and credentialing processes.- Conduct regular audits on charge entries, payment postings, and claim submissions to ensure compliance with industry standards and company policies.- Review coding practices and billing procedures to ensure accuracy in documentation and claims.2. Compliance and Regulatory Adherence:- Ensure all billing and credentialing activities comply with relevant regulations (HIPAA, CMS guidelines, etc.).- Monitor for adherence to payer-specific billing rules and government regulations.- Stay updated on changes in healthcare laws and ensure the team is compliant.3. Consulting and Mentorship:- Serve as a role model and mentor to less experienced personnel on professional standards of performance.- Provide consulting services and lead independent audits and assessments to improve operations and manage risks related to complex technology and processes.- Mentor, train, and enhance the knowledge of Senior/Staff Auditors and other business area teams in auditing and RCM processes.4. Performance Analysis and Reporting:- Analyze audit findings to identify trends, issues, and areas for improvement in the RCM process.- Provide detailed reports on audit outcomes to the HOD Operations, outlining key performance indicators (KPIs), compliance issues, and recommendations for improvement.- Ensure the preparation and delivery of KPI &amp; MTD (Month to Date) reports to track performance, which will directly influence bonuses and incentives for team members.- Work closely with teams to resolve discrepancies and implement solutions to enhance revenue cycle efficiency.5. Follow-up and Remediation:- Follow up on past audit findings to ensure timely and adequate remediation.- Implement corrective action plans based on audit outcomes to enhance overall compliance and financial performance.6. Risk Management and Quality Control:- Identify and mitigate risks associated with the revenue cycle by ensuring strict compliance and best practices in billing and credentialing.- Conduct regular risk assessments and recommend strategies to minimize financial losses or compliance violations.7. Continuous Improvement:- Recommend process improvements to optimize the revenue cycle workflow and enhance operational efficiency.- Lead efforts to implement automation and advanced technology solutions for RCM auditing.- Track performance metrics and recommend actions for improved revenue capture and reduced denials.Qualifications and Skills Education:- Bachelor's degree in Healthcare Administration, Business Administration, Finance, or a related field (required).- Certification in Medical Billing/Coding, RCM, or relevant certifications (e.g., CPC, CPMA) preferred.Experience: - 5+ years of experience in medical billing, credentialing, and RCM auditing, with leadership experience preferred.- Minimum 5 years of full-time working experience in auditing or quality management in RCM or healthcare.Skills: - Knowledge of ISO standards (ISO 9001, ISO 27001) and audit procedures.- Advanced knowledge of Quality Methods, Risk Management, and relevant ISO certifications (ISO 14064-1 experience is an advantage).- Proficiency in billing and auditing software tools (e.g., Epic, Cerner, Kareo, etc.).- Excellent analytical, organizational, and mentoring skills.- Strong communication and leadership abilities.- Professional and mature attitude with the ability to work in fast-paced, dynamic environments.Job Rewards and Benefits:- Paid Leaves- HR Bonus- Loan Policy- Advance Salary- Yearly Loyalty Rewards- Performance-based Bonuses (based on KPI &amp; MTD reports)- Leave Encashment- Inflation Bonus- Promotion- Increments- Medical (TBD)- Employee Contributory Saving Plan- Saturday and Sunday Off- Complimentary Food (Dinner) &amp; Tea/Green Tea (Two times)Job Type: Full-timeWork Location: In person

Auditor Specialist – Revenue Cycle Management (RCM)

Explore 127+ Credentialing specialist in Pakistan this April. Find roles across top companies and apply now to boost your career.

127 credentialing specialist jobs In Pakistan

Credentialing Specialist

Credentialing Specialist

Credentialing Specialist

Medical Credentialing & Enrollment Specialists

Credentialing Team Lead

Management Trainee Officer (night shift)

Auditor Specialist – Revenue Cycle Management (RCM)