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 GrowthJob 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

Credentialing Specialist

MeshSquare

Job description: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.100,000 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: 051 889-2889 WhatsApp: 03708892889Job Type: Full-timePay: Rs100,000.00 - Rs150,000.00 per monthWork Location: In person

Senior Credentialing Specialist (Medical Billing)

Jawa Health Care

Here&rsquo;s Credentialing Job TitleCredentialing Specialist &mdash; Medical Billing / Provider EnrollmentPosition SummaryThe Credentialing Specialist is responsible for managing the full lifecycle of provider credentialing and enrollment with payers (commercial, Medicare, Medicaid, third&#8209;party networks) to ensure that providers are properly authorized to bill and receive reimbursement. This role liaises between providers, payers, billing teams, and internal departments to maintain compliance, minimize credentialing delays, and support revenue integrity.Key Responsibilities / Duties<ul><li>Provider Credentialing &amp; Enrollment</li><li>Prepare, compile, and submit initial credentialing applications to payers, Medicare/Medicaid, IPAs, health networks.</li><li>Manage re&#8209;credentialing and renewals of existing provider credentials.</li><li>Maintain and update provider profiles (e.g. CAQH, NPPES, PECOS, payer portals).</li><li>Obtain and track provider identifiers (Provider IDs, NPI, Tax IDs, etc.).</li><li>Coordinate with providers (physicians, DME, therapists, clinics) to gather required documentation (licenses, board certifications, CVs, malpractice insurance, etc.).</li><li>Follow up on application status, resolve discrepancies, and expedite submissions.</li><li>Verification &amp; Compliance</li><li>Perform primary source verification (PSV) of credentials (licensure boards, education, certifications).</li><li>Audit credentialing files to ensure completeness, accuracy, and consistency.</li><li>Monitor credential expiration dates (licenses, DEA, certifications) and trigger renewals proactively.</li><li>Ensure compliance with payer, state, and regulatory credentialing requirements, including policy changes and updates.</li><li>Data &amp; Documentation Management</li><li>Maintain credentialing databases, logs, tracking systems, and reports on status metrics (turnaround time, backlog, approval rates).</li><li>Document interactions with payers and providers, maintain records of submissions, denials, and appeals.</li><li>Generate periodic credentialing status reports for management and internal stakeholders.</li><li>Stakeholder Communication &amp; Issue Resolution</li><li>Communicate with payers and insurance networks to resolve credentialing issues, contract queries, missing documentation, and provider disputes.</li><li>Liaise with billing, contracting, HR, compliance, legal, and provider offices for credentialing&#8209;related matters.</li><li>Support billing teams in credential&#8209;related denials or rejections (for example, provider not enrolled).</li><li>Process Improvement &amp; Quality Assurance</li><li>Identify credentialing process bottlenecks and suggest workflow improvements.</li><li>Participate in audits, quality checks, and compliance reviews.</li><li>Stay current on industry trends, payer credentialing rules, regulatory changes, and best practices in provider enrollment.</li></ul>Qualifications &amp; Requirements<ul><li>Education: Bachelor&rsquo;s degree preferred (Healthcare Administration, Business, Health Information Management, or related field). Some organizations accept equivalent experience.</li><li>Experience: 2+ years of experience in provider credentialing, enrollment, or similar role (in a medical billing, RCM, or healthcare setting).</li><li>Knowledge / Technical Skills:</li><li>Familiarity with CAQH, NPPES, PECOS, payer portals, credentialing software/platforms.</li><li>Understanding of commercial &amp; government payers (Medicare, Medicaid) credentialing rules.</li><li>Strong knowledge of medical licensure, board certification, education verification, regulatory compliance.</li><li>Proficiency in MS Office (Excel, Word, Outlook).</li><li>Skills / Competencies:</li><li>Strong attention to detail, organizational skills, and ability to manage multiple credentialing tracks simultaneously.</li><li>Excellent written and verbal communication skills.</li><li>Analytical and problem-solving mindset.</li><li>Ability to work independently and interface with multiple stakeholders.</li><li>Discretion and confidentiality in handling provider data.</li><li>Desired / Optional:</li><li>Certification such as CPCS (Certified Provider Credentialing Specialist) or CPMSM.</li><li>Experience with multi&#8209;state credentialing or large group practices.</li><li>Experience with medical billing, claims, or revenue cycle functions.</li><li>Knowledge of HIPAA or healthcare compliance standards.</li></ul>Working Conditions / Schedule<ul><li>This role is generally in office or hybrid/remote (depending on the organization).</li><li>May require working non&#8209;standard shifts (e.g. night shift) if supporting international clients or off&#8209;hours payer windows.</li><li>Keyboard / computer work, calls, email communications.</li><li>Occasional high volume / urgency periods requiring extra effort to meet credentialing deadlines.</li></ul>Key Performance Indicators (KPIs)<ul><li>Turnaround time for credentialing submissions / approvals</li><li>Percentage of credentialing applications approved without rework</li><li>Number of credentialing backlog / pending items</li><li>Accuracy rate (errors in credentialing files)</li><li>Provider uptime (minimizing provider downtime due to credentialing issues)</li></ul>Job Type: Full-timePay: Rs50,000.00 - Rs80,000.00 per monthWork Location: In person

Experienced Credentialing Specialist in medical billing

Zebra Cargo Solutions LLC

Hi everyone,We are looking out for an experienced Credentialling specialist who can do AR executive work as well having an 0 to 3 years of experience into Medical Billing (RCM).Our company is looking for (Credentialling specialist). We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don&rsquo;t fill all of the qualifications, you may still be considered depending on your level of experience.Role &amp; Responsibilities<ul><li>Candidates with self-starter, team player, analytical &amp; problem-solving ability.</li><li>Candidates must have experience managing high volume in a fast-paced environment.</li><li>Candidates with the ability to utilize the technology available, including use and navigation of Microsoft Word, Excel, and Outlook, as well as Internet functions.</li><li>Candidates associated with any degree or equivalent experience or any satisfactory combination of experience and training, which demonstrates the knowledge, skills, and abilities to perform duties.</li></ul>Interview;- IN-PersonJob Type: Full-timePay: &#8377;20,000.00 - &#8377;30,000.00 per monthExperience:<ul><li>total work: 3 years (Required)</li></ul>Work Location: In person

Credentialing Specialist, AR Executive and Charge Posting (Medical Billing )

We are looking for a Credentialing Coordinator 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>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(6pm to 3am)?</li><li>Will you be able to commute to Bahria Town Phase 7 Rawalpindi?</li></ul>Work Location: In person

Credentialing Manager

CareSTL Health

<div><div>POSITION TITLE: Director of Human Resources</div>
<div></div><div>REPORTS TO: Chief Human Resources Officer</div>
<div></div><div><div>CLASSIFICATION: Exempt</div> 
<div></div>
<div></div><div><div>POSITION SUMMARY: The Director of Human Resources serves as a role model, creating positive relationships with staff in an environment of mutual respect and trust. The Director is a strong advocate for employees, cultivates and enhances an atmosphere of continuous improvement, and is involved in creating a customer focus within CareSTL Health. The Director participates in the development of a leadership system based upon CareSTL Health's mission, values, and high performance expectations while working collaboratively with the Chief Human Resources Officer. Promote performance excellence through maintaining a focus on execution of strategic and organizational planning, use of quality processes and goals, and decision-making based on data and analysis. The Director of Human Resources supports the professional development of staff and communicates in a manner that energizes the work force, promotes retention, encourages team excellence, and facilitates continuous learning and reinforces positive partnerships throughout CareSTL Health and in the community.</div>
<div></div><div>ESSENTIAL FUNCTIONS:</div>
<div>The following information is considered the definition of essential functions but does not restrict the tasks that may be assigned. The Director of Human Resources may be reassigned duties and responsibilities at any time due to reasonable accommodation or other staffing reasons.</div>
<ul><li>Assists the CHRO in implementing the health center&rsquo;s mission and strategic plan.</li>
<li>Demonstrates, through behavior, CareSTL Health&rsquo;s core values of customer services, community collaboration, comprehensive, compassion and competence.</li>
<li>(1) Responsible for effective and efficient management of day to day operations and delivery of HR programs and services; includes the management of technology, processes, people, vendors and other resources and serve as a Human Resources advisor for employee actions (i.e. performance improvement, terminations, etc.) and advises management on best HR practices.</li>
<li>(2) Drive continuous improvement and operational efficiencies in HR processes and procedures; design and implement innovative solutions where applicable and establish internal metrics to measure and evaluate HR&rsquo;s operational effectiveness.</li>
<li>(3) Responsible for the oversight of all employee credentialing in accordance with applicable organization policy, protocol, regulatory entities and employment laws.</li>
<li>(4) Provide direction and support in all aspects of employee relations functions and programs designed to establish and maintain positive and effective employee relations through the uniform and equitable application of company policies and procedures and serve as a resource and provide assistance to employees on personnel-related issues, including conflict resolution mitigating employment legal risks.</li>
<li>(5) Deliver comprehensive recruiting program resulting in qualified and retainable candidate and manage the CareSTL Health On-boarding Program</li>
</ul><div>OTHER DUTIES:</div>
<ul><li>Ensure the highest levels of data management, accuracy and confidentiality for all HR Systems.</li>
</ul><ul><li>Develop, implement and maintain procedures to ensure compliance and confidentiality of all employment materials, files and records.</li>
<li>Orient new leadership personnel to HR function and explain HR policies, procedures, benefits, employee relations, etc., as established in HR policies and procedures.</li>
<li>Maintain confidentiality of all pertinent HR information in accordance with, HIPAA and other Federal and State privacy laws, as well as established HR and organization policies governing confidential information.</li>
<li>Develop and implement retention strategies to include policies and plans that CareSTL Health follows to reduce employee turnover and attrition and ensure employees are engaged and productive long-term. Ensure the retention strategy aligns with business goals to ensure maximum return on investment.</li>
<li>Analyze exit interview feedback and develop new techniques to ensure employee retention.</li>
</ul><ul><li>Develops and maintains a human resource information system that meets the organization's information needs. Provides necessary reports for critical analyses of the HR function and the people resources of CareSTL Health.</li>
<li>Analyze and report the need for system enhancement or customization.</li>
<li>Support the implementation/maintenance of various modules within PayCor.</li>
<li>Primary liaison for PayCor HRIS/Payroll system.</li>
<li>Determine the validity of other modules within PayCor (HRIS) and ensure current modules are being utilized and optimized to the fullest.</li>
<li>Recommend changes to current processes to provide more effective use of the HRIS, and take the lead to implement these changes (i.e. on-boarding and exits, org charts, employment changes, performance management, recruitment, etc.).</li>
</ul><ul><li>Develop and oversee HR scorecard and critical metrics, reports, and analytics in order to facilitate better decision making and meeting strategic targets.</li>
</ul><ul><li>Responsible for the HR storage of documentation (paper &amp; electronic) and the overall archiving process; responsible for implementing processes and systems that allow for paperless processing yet help us remain compliant for audits.</li>
<li>Support the preparation of documentation, reports for all internal and external audits.</li>
</ul><div>JOB REQUIREMENTS AND QUALIFICATIONS:</div>
<div></div><div>Education:
</div><ul><li>Bachelor&rsquo;s degree in Human Resources Management or related discipline (required)</li>
</ul><div>Experience:</div>
<ul><li>7 years professional experience as a HR Generalist and 2 years of Supervision, preferably in a non-profit and/or foundation set or equivalent years of experience.</li>
<li>CPP, PHR, SPHR, SHRM-CP or SHRM-SCP certification preferred.</li>
<li>A proven track record in designing/developing/directing innovative program development within a complex and rapidly changing environment.</li>
<li>Working knowledge of multiple human resource disciplines, organizational diagnosis, employee relations, diversity, performance management, and federal and state respective employment laws.</li>
<li>Exceptional interpersonal skills</li>
<li>Demonstrated ability to create innovative approaches to solving challenging problems within the competitive healthcare industry.</li>
<li>Must reflect the professional image of the company, upholding the company vision in actions, demeanor and appearance.</li>
</ul>
<div></div><div>Knowledge, Skills and Abilities:</div>
<ul><li>Good organizational and self-motivational skills</li>
<li>Experience with Accounting Software, Payroll Software, Applicant Tracking Systems (ATS) or Human Resource Information Systems (HRIS) and MS Office Suite</li>
<li>Creative problem solver with subject matter expertise and experience in a broad range of HR functions and roles.</li>
<li>Work effectively in a fast-paced, deadline-driven environment. Must be able to demonstrate speed, flexibility, adaptability and ability to work under pressure.</li>
<li>Demonstrated ability to drive accountability and maturity within the HR organization</li>
<li>Strong communication skills with the ability to communicate effectively with all levels of leadership and employees; both in oral and written form.</li>
<li>Proven track record in partnering with leadership teams to maximize organizational effectiveness.</li>
<li>Demonstrated business and customer service acumen</li>
<li>Passion for enhancing the employee experience.</li>
<li>A strong understanding of government contracting rules and regulations and how they affect employees, employee programs and practices.</li>
<li>Strong analytical skills.</li>
<li>Demonstrated ability to develop long-term plans and programs.</li>
<li>Excellent planning and organizational skills, attention to detail, and ability to multi-task.</li>
<li>Conflict resolution and negotiations skills.</li>
</ul><div>Transportation Requirement:
</div><ul><li>Must have a valid Driver&rsquo;s License and Reliable Transportation</li>
</ul><div>Supervisory Responsibility:
</div><ul><li>HR Generalist</li>
<li>Recruitment &amp; Credentialing Specialist</li>
</ul><div>Additional Eligibility Qualifications (licenses, programs, certificates, pre-employment check and post and annual screening(s)</div>
<ul><li>Copy of High School Diploma</li>
<li>Copy of College Diploma or Transcripts</li>
<li>Current Registration with the Missouri Family Care Safety Registry</li>
<li>Annual PPD or Chest X-Ray</li>
</ul><div>Training Requirements (licenses, programs, or certificates)
</div><ul><li>SPHR or PHR (Preferred)</li>
</ul>
<div>Additional Information:
<ul><li>Clinic hours are Monday - Friday 8 a.m. to 5 p.m.</li>
<li>11 paid holidays per year.</li>
<li>Full benefits package.</li>
<li>Public Service Loan Forgiveness.</li>
</ul>
*We believe that health care is right and not a privilege. At CARESTL HEALTH we are an equal opportunity employer healthcare center. All applicants will be considered for employment without attention to race, color, sex, national origin, religion, veteran, or disability status.*</div></div></div></div>

Director of Human Resources

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 for our Medical billing/AR/Credentialing teams and looking for candidates who are willing to learn and apply themselves in a short period of time. Job Description<ul><li>Medical records evaluation</li><li>Insurance eligibility verification</li><li>Claim generation and submission</li><li>Follow-up on pending claims</li><li>Account Receivables</li></ul>Requirements<ul><li>Night shift availability (7pm to 4am)</li><li>Mondays to Fridays</li><li>Graduation (required)</li><li>English Proficiency is must</li></ul>Location 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 and begin your journey of becoming an integral part of the Claims Med family.Job Type: Full-timePay: Rs45,000.00 - Rs50,000.00 per monthWork Location: In person

Medical Billing Analyst(Male)

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