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credentialing specialist

CloudRCM Solutions

CloudRCM Solutions is a leader in healthcare revenue cycle management, committed to delivering efficient and reliable solutions to our clients. We pride ourselves on fostering a professional and collaborative work environment. We are currently looking for a Credentialing Specialist with at least 3 year of experience to join our growing team.Job Summary: As a Credentialing Specialist, you will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with payer requirements and industry standards.Key Responsibilities:<ul><li>Provider Credentialing:</li><li>Process credentialing applications for healthcare providers.</li><li>Verify and maintain accurate provider information with insurance companies and regulatory bodies.</li><li>Ensure all documentation is complete, accurate, and submitted within deadlines.</li><li>Communication and Coordination:</li><li>Serve as the primary point of contact for providers regarding credentialing updates and requirements.</li><li>Liaise with insurance companies, healthcare facilities, and internal teams to resolve credentialing issues.</li><li>Compliance Management:</li><li>Maintain compliance with industry regulations, accreditation standards, and payer requirements.</li><li>Track license renewals, certifications, and other required documents.</li><li>Data Management:</li><li>Update and maintain provider credentialing databases.</li><li>Generate regular reports on credentialing status and activities.</li><li>Problem Solving:</li><li>Address and resolve issues related to provider enrollment and credentialing delays.</li><li>Ensure smooth onboarding of new providers by coordinating credentialing activities</li></ul>EXPERIENCE REQUIRED:<ul><li>3 year of experience in provider credentialing or a related field.</li><li>Knowledge of healthcare credentialing processes and payer enrollment requirements.</li><li>Familiarity with credentialing software and databases.</li><li>Strong attention to detail and organizational skills.</li><li>Excellent communication skills (verbal and written).</li><li>Ability to work independently and manage multiple tasks in a deadline-driven environment.</li><li>Proficiency in MS Office (Word, Excel, Outlook).</li></ul>Joining: Immediate joining Within a weekJob Type: Full-time Shift: (6:00 PM - 3:00 AM) Night shift Job Location: Bahria Phase 4, RawalpindiJob Type: Full-timeWork Location: In personExpected Start Date: 13/10/2025

Credentialing Specialist

Speak Viral

We are looking for a Credentialing Specialist to join our team and oversee administrative tasks dealing with our health facility&rsquo;s credentialing.Credentialing Coordinator responsibilities include maintaining and verifying files and tracking the expiration of certifications throughout the organization.Ultimately, you will work with different departments across our organization to ensure staff members have the necessary accreditations needed throughout the year.Responsibilities<ul><li>Identify discrepancies in information and conduct follow-ups</li><li>Present applications to the facility&rsquo;s Credentialing Committee</li><li>Assist customers with credentialing inquiries</li><li>Respond to health plan provider inquiries</li><li>Capture primary source documentation in computer databases</li><li>Ensure data is backed up</li><li>Follow compliance laws, regulations, procedures, and policies</li></ul>Requirements and skills<ul><li>Proven work experience as a Credentialing Coordinator or similar role</li><li>Excellent verbal and written communication skills</li><li>Expertise with Microsoft Office Word and Excel</li><li>Proficient touch-typing skills</li><li>Ability to focus for extended periods</li><li>Relevant training and/or certifications as a Credentialing Coordinator</li></ul>Benefits: Increment after Probation Annual Increment Free Meal/Tea Career Growth Job Type: Full-time, Night Shift from 6pm to 3am (Mon-Fri)Job Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthApplication Question(s):<ul><li>Will you be able to work in night shift(6pm to 3am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

DevStudio Agency

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-timeJob Type: Full-timeWork Location: Remote

Meds IT Nexus

Position: Senior Credentialing SpecialistCompany: Meds NexusLocation: Office # 1st, 5th Floor, Gold Mark Plaza, Asghar Mall Rd, Asghar Mall Scheme, Rawalpindi, Punjab 46000Job Timing: 05:30 PM To 02:30 AM (EVENING SHIFT)Job Type: Night ShiftExperience Required: 2-3 yearsPosition Available: 2Special Note: This job is not for fresh candidates.About Us:Meds Nexus is a leading medical billing company based in Rawalpindi, dedicated to streamlining healthcare financial processes. We are actively seeking a detail-oriented and motivated individual to join our Credentialing team as a Senior Credentialing Specialist.Key Responsibilities:- Accurately complete credentialing and reappointment applications for Outpatient and ABA providers.- Track progress of applications and report to Client Managers/Team Leaders.- Monitor and update provider portals for accurate information.- Maintain current provider records electronically and in hard copy folders.- Assist in obtaining required documentation from providers.- Prepare professional communication to providers, payers, and facilities.- Understand the impact of credentialing on billing, contracts, and EDI.- Investigate and determine solutions to problems.- Communicate clearly and professionally with team members, payers, and credentialing representatives.- Process ERA &amp; EFT applications.- Have brief knowledge of Government, MCOs, and commercial insurance enrollments.Salary Package:- Basic: up to Rs.80,000 per monthJob Rewards and Benefits:- Paid Leaves- HR Bonus- Loan Policy- Advance Salary- Yearly Loyalty Rewards- Leave Encashment- Inflation Bonus- Promotion- Increments- Medical (TBD)- Employee Equity Funds Program (EEFP)- Saturday and Sunday Off- Complementary Food (Dinner) &amp; Tea/Green Tea (Two times)How to Apply:If you are ready to contribute to a dynamic team and take the next step in your finance career, please submit your resume and a cover letter outlining your relevant experience to hr@medsnexus.com. Please include &quot;Account Assistant Application&quot; in the subject line.Application Deadline: On an urgent basisMeds Nexus is an equal-opportunity employer. We encourage applications from candidates of all backgrounds and experiences.Contact Information:- Email: hr@medsnexus.com- Phone: 051 889-2889Job Type: Full-timeJob Type: Full-timePay: Rs50,000.00 - Rs80,000.00 per month

Senior Credentialing Specialist (Medical Billing)

CloudRCM Solutions is a leader in healthcare revenue cycle management, committed to delivering efficient and reliable solutions to our clients. We pride ourselves on fostering a professional and collaborative work environment. We are currently looking for a Credentialing Specialist with at least 3 year of experience to join our growing team.Job Summary: As a Credentialing Specialist, you will be responsible for managing the credentialing process for healthcare providers, ensuring compliance with payer requirements and industry standards.Key Responsibilities:<ul><li>Provider Credentialing:</li><li>Process credentialing applications for healthcare providers.</li><li>Verify and maintain accurate provider information with insurance companies and regulatory bodies.</li><li>Ensure all documentation is complete, accurate, and submitted within deadlines.</li><li>Communication and Coordination:</li><li>Serve as the primary point of contact for providers regarding credentialing updates and requirements.</li><li>Liaise with insurance companies, healthcare facilities, and internal teams to resolve credentialing issues.</li><li>Compliance Management:</li><li>Maintain compliance with industry regulations, accreditation standards, and payer requirements.</li><li>Track license renewals, certifications, and other required documents.</li><li>Data Management:</li><li>Update and maintain provider credentialing databases.</li><li>Generate regular reports on credentialing status and activities.</li><li>Problem Solving:</li><li>Address and resolve issues related to provider enrollment and credentialing delays.</li><li>Ensure smooth onboarding of new providers by coordinating credentialing activities</li></ul>EXPERIENCE REQUIRED:<ul><li>3 year of experience in provider credentialing or a related field.</li><li>Knowledge of healthcare credentialing processes and payer enrollment requirements.</li><li>Familiarity with credentialing software and databases.</li><li>Strong attention to detail and organizational skills.</li><li>Excellent communication skills (verbal and written).</li><li>Ability to work independently and manage multiple tasks in a deadline-driven environment.</li><li>Proficiency in MS Office (Word, Excel, Outlook).</li></ul>Joining: Immediate joining Within a weekJob Type: Full-time Shift: (6:00 PM - 3:00 AM) Night shift Job Location: Bahria Phase 4, RawalpindiJob Type: Full-timeWork Location: In personApplication Deadline: 28/07/2025 Expected Start Date: 01/10/2025

Sr. Credentialing Analyst

AltuMed (Cube Healthcare Systems Pvt Ltd)

Job Description:Education:Bachelor&rsquo;s DegreeMinimum Experience: 5&ndash;6 years of experience in billing operations with at least 2 years in a Supervisor or Assistant Manager role.Skills:<ul><li>Strong understanding of RCM processes: claim entry, coding, AR, denials, follow-up, appeals, reporting credentialing, and collections.</li><li>Hands-on experience with EMRs and billing platforms. Proficient in Excel and capable of handling data-driven reports and dashboards.</li><li>Excellent leadership, communication, and problem-solving skills.</li></ul>Responsibilities:<ul><li>Manage multiple RCM teams through Team Leads and Supervisors. Manage proactively in the absence of Team Leads and Supervisors.</li><li>Oversee daily operations including charge entry, claims submission, payment posting, AR follow-up, denial management, and reporting.</li><li>Monitor team productivity, accuracy, and workflow distribution.</li><li>Collaborate with Team Leads &amp; Account Managers to understand service expectations, address escalations, and implement workflow improvements as per the need to clients.</li><li>Participate in client review calls and provide performance updates. Ensure all client SLAs and contractual KPIs are consistently met. Drive improvements based on trends and gaps.</li><li>Coach, mentor, and support Team Leads and Billing Executives in achieving personal and team goals.</li><li>Conduct performance reviews, set improvement plans, and identify training needs.</li><li>Review, validate, and analyze operational reports.</li><li>Present actionable insights and performance dashboards to senior management and clients.</li></ul>Benefits:Market-Leading Salary, Medical insurance, Provident fund, EOBI, Paid Leaves, cash advance, Employee Performance based bonuses, Annual increments, Allowances ( Accommodation, OPD, Travel, Night, utilities, Technical ), Parental Leaves, Annual dinners &amp; tripsNote: Preference will be given to candidates from Hazara Division, KPK for this specific role. However, candidates from all over the Pakistan are welcomed.Job Type: Full-timeWork Location: In personJob Type: Full-timeWork Location: In person

Assistant Manager RCM Operations

HiRe Solutions

Alpha Hire Solutions | Islamabad/ Shift: Night (6:00 PM &ndash; 2:00 AM PKT)Alpha Hire Solutions is seeking a skilled and motivated Cold Caller / Business Development Executive to join our dynamic team providing Medical Billing and related services. This is an excellent opportunity for professionals with experience in dealing with U.S.-based healthcare providers who are looking for stability, growth, and career advancement in a performance-driven environment.Key Responsibilities&middot; Manage inbound and outbound calls, number of calls as communicated by the management daily to medical practices, physicians, and healthcare providers to set appointments for Lead Closers..&middot; Assist in generating leads from various applications/resources available under the guideline of Management.&middot; Consistently meet call quality, productivity, and performance targets.&middot; Collaborate with the designated personnel to achieve daily and monthly goals.&middot; &middot; Introduce and explain the company&rsquo;s medical billing services in a clear and professional manner.&middot; &middot; Qualify leads by identifying needs, decision-makers, and timelines.&middot; &middot; Schedule appointments or follow-ups for the sales or business development team.&middot; &middot; Maintain detailed records of calls, conversations, outcomes, and lead status in CRM software.&middot; &middot; Follow up with potential clients via phone or email as needed.&middot; &middot; Handle initial objections and provide basic responses to common questions.&middot; &middot; Stay updated on the company&rsquo;s services, features, and industry trends.&middot;Requirements&middot; 2&ndash;3 years of proven experience in U.S. based medical billing, credentialing, revenue cycle management, or related healthcare services.&middot; Excellent verbal communication skills with a customer-centric approach.&middot; Strong problem-solving abilities and attention to detail.&middot; Ability to work effectively in a fast-paced, target-oriented environment.&middot; Must be available to work on-site night shift ((6:00 PM &ndash; 2:00 AM PKT)What We Offer&middot; Competitive salary package with attractive performance-based incentives.&middot; Professional and growth-oriented workplace culture.&middot; Ongoing training and clear career advancement opportunities.If you are passionate about medical billing and want to grow in a supportive yet challenging environment, we&rsquo;d love to hear from you!Job Type: Full-timePay: Rs70,000.00 - Rs80,000.00 per monthWork Location: In person

Medical Billing – Caller (Night Shift | Onsite)

Explore 467+ Credentialing specialist in Pakistan this October. Find roles across top companies and apply now to boost your career.

467 credentialing specialist jobs IN Pakistan

Credentialing Specialist

Credentialing Specialist

Credentialing Specialist

Senior Credentialing Specialist (Medical Billing)

Sr. Credentialing Analyst

Assistant Manager RCM Operations

Medical Billing – Caller (Night Shift | Onsite)