credentialing specialist

ar specialist in medical billing Jobs in Pakistan

ar specialist in medical billing

customer service specialist Jobs in Pakistan

customer service specialist

customer services specialist Jobs in Pakistan

customer services specialist

healthcare service plan specialist

GrowthRatio Solutions

Healthcare Service Plan Specialist Location: Bahria Town Phase 7 RawalpindiWorking Hours: 1:30 PM &ndash; 10:30 PM (PKT) | Monday &ndash; FridayStart Date: ASAPAbout the RoleWe&rsquo;re looking for a detail-oriented and highly analytical professional to join our growing healthcare operations team. In this role, you&rsquo;ll be responsible for crafting accurate, compliant, and personalized service plans for seniors seeking home care support.If you have a strong background in medical billing, healthcare documentation, and compliance (HIPAA) and you thrive in structured, process-driven environments this role is designed for you.Key Responsibilities<ul><li>Develop and update individualized service plans based on patient needs and medical data</li><li>Ensure all documentation is accurate, complete, and audit-ready</li><li>Review service plans to ensure full compliance with regulatory and program guidelines</li><li>Collaborate closely with Service Coordinators to maintain efficient workflow and timely delivery</li><li>Manage multiple active cases while maintaining high-quality standards</li><li>Handle sensitive healthcare data with strict adherence to HIPAA compliance protocols</li></ul>What We&rsquo;re Looking For<ul><li>Strong writing and analytical skills (critical for documentation accuracy)</li><li>Exceptional attention to detail and organizational ability</li><li>Ability to manage multiple deadlines and case workflows simultaneously</li><li>Proficiency in digital tools, documentation systems, and spreadsheets</li><li>Clear and professional communication skills</li></ul>Required Experience<ul><li>Experience in medical billing (mandatory)</li><li>Familiarity with HIPAA compliance and handling sensitive medical data (mandatory)</li><li>Background in healthcare, case management, or service plan writing (preferred)</li></ul>Why Join Us?<ul><li>Work with an international healthcare team</li><li>Gain exposure to structured U.S. healthcare systems and compliance standards</li><li>Stable, long-term opportunity with clear workflows and defined processes</li></ul>How to Apply Send your resume at 03078908971Job Type: Full-timePay: From Rs70,000.00 per monthWork Location: In person

Healthcare Service Plan Specialist

Top Line Resource Group (TLRG)

Location: DHA Phase 8, Lahore [Onsite]Employment Type: Full-timeWork Timing: 05 PM &ndash; 02 AM Pakistan Time (US Business Hours)Job OverviewTopline Resource Group (TLRG) is seeking a dedicated Eligibility &amp; Authorization Specialist to manage the critical front-end operations for our US-based healthcare clients. This role is focused entirely on securing the financial foundation of the practice by ensuring every patient has active coverage and every procedure has the required clinical approval before services are rendered.Key Responsibilities<ul><li>Verify patients' insurance coverage and eligibility in real-time to ensure policies are active and services are covered on the specific Date of Service (DOS).</li><li>Obtain pre-authorizations from insurance companies for medical procedures and treatments.</li><li>Communicate directly with patients regarding their insurance status, coverage specifics, and any required actions or out-of-pocket responsibilities.</li><li>Maintain accurate and meticulous records of insurance verifications and authorizations, including representative names and unique reference numbers for audit trails.</li><li>Collaborate with healthcare providers to ensure all necessary clinical information, physician notes, and CPT/ICD-10 codes are obtained for successful pre-authorizations.</li><li>Monitor and follow up on pending authorizations daily to ensure timely processing and stay within the 7&ndash;10 day payer response window.</li><li>Analyze insurance benefits to identify exact copays, unmet deductibles, and co-insurance percentages to ensure accurate front-end collections.</li><li>Identify if the provider is in-network or out-of-network and determine if specific plan tiers (HMO/EPO) require a PCP referral before the visit.</li><li>Stay up to date with insurance policies, CMS regulations, and HIPAA guidelines to ensure 100% compliance across all US healthcare accounts.</li><li>Track and manage KPIs, including the clean claim rate and authorization turnaround time, to reduce AR aging and increase collection rates.</li></ul>Required Qualifications<ul><li>3+ years of experience in US Medical Billing, specifically focused on Front-End operations (Eligibility and Authorizations).</li><li>Expert-level familiarity with CPT, ICD-10, and HCPCS codes and their specific relationship to authorization requirements.</li><li>Deep understanding of US insurance plans, including Medicare, Medicaid, HMO, PPO, and Commercial plans.</li><li>Hands-on experience with EHR/EMR systems, Practice Management software, and major US payer portals (Availity, Navinet, etc.).</li><li>Excellent verbal and written English communication skills for professional interaction with US insurance companies and clinical teams.</li><li>Strong analytical ability to interpret Verification of Benefits (VOB) reports and payer medical necessity criteria to resolve issues before service delivery.</li></ul>Pay: Rs100,000.00 - Rs125,000.00 per monthExperience:<ul><li>eligibility &amp; authorization: 2 years (Required)</li></ul>Work Location: In person

Eligibility & Authorization Specialist

Aga Khan University

<div><div>Specialist, Data Governance - (260001DY)</div><div><div> 
</div>Specialist, Data Governance 
 
Entity: Aga Khan University
Location: Karachi 
 
Introduction to the Aga Khan University: 
The Aga Khan University is a private, international university committed to international standards of excellence in teaching, research, and service. Its teaching hospital, the Aga Khan University Hospital has been accredited by the prestigious Joint Commission International for achieving the highest international healthcare standards.
Job Role / Responsibilities: 
You will work as an expert in the Data Governance team which is part of the Global Data &amp; Analytics Office (GDAO) for the development and implementation of Data Governance policies &amp; frameworks to set the ground for services such as a Data Catalog, ETL/ELTs, Data Quality, Data Lineage, etc.
Specifically, you will be responsible to;
<ul><li>Evaluate available Data Governance related tools and solutions in the market and plan for their pilots and implementations at AKU</li>
<li>Work on developing or standardizing different aspects of data governance including Data Quality, Metadata Management, Master and Reference Data Management and Data Management maturity model</li>
<li>Remain aware of regulatory requirements of the region and governing bodies related to Data Management and translate those into updates to policies and processes</li>
<li>Build operational inventories of Data Assets residing with departments in all AKU&rsquo;s departments and entities
</li><li>Develop and promote rollout of the Data policy and procedures trainings and communications in all departments and entities globally</li>
<li>Develop central artefacts to develop common definitions for the institutions and engage stake holders to implement and maintain uniformity</li>
<li>Understand the requirements and develop proposals for automation and work to implement processes after agreement of all stakeholders.</li></ul></div><div></div><div> 
<div></div>Eligibility Criteria / Requirements:
<ul><li>Undergraduate Degree in Computer Science or equivalent or Graduate degree and/ or Certifications in Data Analytics/ Informatics will be an added advantage</li>
<li>More than three years of experience of working in a large (preferably multinational) organization in a Data Governance, Data Science or related team</li>
<li>Should have worked on projects for the implementation of Data organization and cataloguing software at the enterprise level</li>
<li>Thorough understanding of Data Management body of knowledge</li>
<li>Skilled in drafting and rolling out policies and processes for large scale organizations to cater to regulatory, security and strategic requirements</li>
<li>High level knowledge of enterprise tools and systems for Data Governance &amp; Data Science</li>
<li>Demonstrated ability of delivering projects with multiple stakeholders within given timelines</li>
<li>Working knowledge of Data Science/ Machine Learning related tools and practices</li>
<li>Good interpersonal and communication skills.</li>
</ul>
</div><div></div><div>Primary Location: Pakistan</div><div>
Organisation: Aga Khan Hospital &amp; Medical College</div><div>
Employee Status: Regular</div><div>
Job Type: Standard</div><div>
Job Posting: 16/04/2026, 11:34:11 PM</div><div>
Closing Date: 30/04/2026, 1:59:00 PM</div></div>

Specialist, Data Governance

TechDigit Solutions

<div>
 
 
 Company Description
 
 
 
 TechDigit Solutions, founded in 2020, provides specialized services in Medical Billing &amp; Revenue Cycle Management, Cybersecurity, Customer Support, and Professional Writing. Known for its commitment to quality and transparency, TechDigit Solutions maintains an industry-leading denial rate of only 5&ndash;8% for US healthcare providers, far below the 15&ndash;25% average.
 
 
 
 
 
 
 Job Summary:
 
 
 
 A Certified Medical Coding &amp; Billing Specialist is responsible for accurately translating healthcare services into standardized codes and ensuring timely and accurate billing and reimbursement This role supports healthcare providers by maintaining compliance with regulations and optimizing revenue cycle processes
 
 
 
 
 
 
 Key Responsibilities:
 
 
 
 * Review patient medical records to assign appropriate diagnosis and procedural codes (e.g, ICD, CPT, HCPCS)
 
 
 * Ensure coding accuracy and compliance with federal, state, and payer regulations
 
 
 * Prepare and submit insurance claims to private and government payers
 
 
 * Verify patient insurance coverage and eligibility,
 
 
 * Follow up on denied or unpaid claims and resolve billing issues &bull; Maintain patient billing records and ensure confidentiality (HIPAA compliance)
 
 
 * Communicate with healthcare providers, insurance companies, and patients regarding billing questions
 
 
 * Stay updated on coding guidelines, regulations, and industry changes
 
 
 * Assist with audits and provide documentation when needed
 
 
 Required Qualifications:
 
 
 * Certifications such as CPC (Certified Professional Coder). CCS Certified Coding Specialist), or CBCS (Certified Billing &amp; Coding Specialist)
 
 
 * High school diploma or equivalent (Associate degree in Health Information Management preferred
 
 
 ‣ Knowledge of medical terminology, anatomy, and healthcare documentation
 
 
 * Familiarity with coding systems (ICD-10-CM, CPT, HCPCS Level II &bull; Experience with electronic health records (EHR) and billing software
 
 
 
 
 
 
 Preferred Skills:
 
 
 
 * Strong attention to detail and accuracy &bull; Analytical and problem-solving skills
 
 
 * Good communication and interpersonal abilities &bull; Ability to work independently and meet deadlines &bull; Organizational and time management skills
 
 
 
 
 
 
 Send your resume at hr@techdigitsolutions.com
 
 
</div>

Certified Medical Coder

Global Clinical Cura

Tender Specialist (Healthcare)Location: Islamabad ( Bahria Phase 7) Experience Required: Minimum 3 Years Immediate Joiners PreferredWe are seeking a Tender Specialist with 3+ years of experience in healthcare, pharmaceutical, or medical equipment tenders, along with hands-on exposure to regulatory affairs processes.Key Responsibilities (Healthcare-Specific JD):<ul><li>Identify and manage hospital, government, semi-government, and private healthcare tenders</li><li>Prepare and submit technical, financial, and compliance documents for medical devices, diagnostics, pharmaceuticals, and healthcare solutions</li><li>Ensure tender documents are aligned with DRAP, PPRA, and hospital procurement requirements</li><li>Coordinate with regulatory affairs team for product registrations, renewals, import permits, and compliance documents</li><li>Manage vendor enlistment, pre-qualification, and principal company documentation</li><li>Liaise with sales, supply chain, finance, and operations teams for pricing, stock availability, and delivery commitments</li><li>Prepare BOQs, bid bonds, performance guarantees, and supporting certifications</li><li>Handle correspondence for clarifications, sample submissions, and post-bid evaluations</li><li>Maintain complete record of tender submissions, comparative sheets, and award status</li><li>Support contract execution, purchase order compliance, and post-award documentation</li></ul>Requirements:<ul><li>Minimum 3 years of healthcare/pharma/medical devices tender experience</li><li>Strong understanding of DRAP regulations, PPRA rules, and hospital procurement process</li><li>Experience in handling product registration and regulatory documentation</li><li>Strong command over MS Excel, Word, and e-procurement portals</li><li>Immediate joiners will be highly preferred</li></ul>Apply at: hr@gcc-health.com WhatsApp CV: 03268047081Pay: Rs65,000.00 - Rs90,000.00 per monthWork Location: In person

Tender Specialist (Healthcare)

CrecenTech

CrecenTech Systems Private Limited is hiring a Senior Business Development Specialist &ndash; Medical Billing to support business growth within the international healthcare and Revenue Cycle Management (RCM) services market. This role focuses on developing new business opportunities and building long-term relationships with healthcare organizations.Key Responsibilities<ul><li>Identify and develop new business opportunities for Medical Billing and RCM services</li><li>Conduct outbound prospecting through calls, emails, and professional networking platforms</li><li>Engage with healthcare providers to understand billing and revenue cycle requirements</li><li>Present service solutions related to Medical Billing, Coding, Accounts Receivable, and Denial Management</li><li>Support proposal preparation, pricing discussions, and contract closure</li><li>Maintain accurate sales pipelines and activity records using CRM tools</li><li>Coordinate with internal teams to ensure smooth client onboarding and service delivery</li><li>Work toward assigned monthly and quarterly business objectives</li><li>Stay updated on healthcare industry practices and compliance standards</li></ul>Required Qualifications<ul><li>Bachelor&rsquo;s degree in Business, Marketing, Healthcare Management, or a related field</li><li>3+ years of experience in business development or sales (experience in medical billing services is a plus)</li><li>Understanding of medical billing and revenue cycle workflows</li><li>Strong professional communication and relationship-building skills</li><li>Experience using CRM or sales management tools</li><li>Ability to work with international clients and flexible schedules</li></ul>Preferred Qualifications<ul><li>Experience selling Medical Billing, Coding, or RCM-related services</li><li>Familiarity with professional networking and lead generation tools</li><li>Prior exposure to healthcare service environments</li></ul>Benefits:<ul><li>At least two bonuses per year (Eid Bonus)</li><li>Commission Offered</li><li>Performance-Based Bonuses</li><li>Maternity/Paternity Allowance</li><li>Maternity Leaves</li><li>Wedding Allowance</li><li>Annual Leaves Encashment</li><li>Double salary on Gazetted Holidays</li><li>Special Allowance for Emergency</li><li>12 Casual Leaves</li><li>10 Medical Leaves</li><li>10 Annual Leaves</li><li>Dedicated Training</li><li>Birthday celebrations</li><li>Gaming Facility</li><li>Growing &amp; Dynamic Team</li><li>Office Gatherings, Celebrations, and Trips</li><li>5 days a week (work-life balance)</li></ul>Job Location: Link Road Model Town, Lahore Job Timings: 6 PM to 3 AM (5 days a week)Job Type: Full-timeApplication Question(s):<ul><li>How many years of experience do you have in business development or sales?</li><li>Are you comfortable conducting outbound prospecting through calls, emails, and professional networking platforms?</li><li>Are you comfortable working in night Shift?</li><li>What are your expected salary?</li></ul>Experience:<ul><li>Medical Billing: 3 years (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>Location:<ul><li>Lahore Model Town (Required)</li></ul>Work Location: In person

BD Specialist – Medical Billing

Standard High School & College

Job Title: Medical Billing and Credentialing Specialist Company: Deosai Medical Services Location: I-8, Islamabad (On-site) Job Type: Full-time Reports To: Medical Billing and Credentialing ManagerJob Summary:The Medical Billing and Credentialing Specialist at Deosai Medical Services is responsible for overseeing all billing processes and managing provider credentialing. The role ensures timely and accurate submission of claims to insurance companies while verifying the credentials of healthcare providers to maintain compliance with regulatory standards. This specialist will work closely with providers, insurance companies, and internal teams to optimize billing accuracy and ensure proper credentialing.Key Responsibilities:Billing:<ul><li>Submit and process medical claims to insurance companies in compliance with all regulations.</li><li>Ensure accuracy in coding (CPT, ICD-10, HCPCS), modifiers, and documentation before submission.</li><li>Follow up on denied or rejected claims and manage appeals as necessary.</li><li>Track and resolve outstanding accounts receivables.</li><li>Send out patient bills, handle inquiries, and process payments.</li><li>Maintain accurate patient and insurance records</li></ul>Credentialing:<ul><li>Manage credentialing and re-credentialing processes for healthcare providers.</li><li>Ensure all providers comply with state and federal regulations, including licenses and certifications.</li><li>Complete and submit credentialing applications to insurance carriers and healthcare organizations.</li><li>Track credentialing status and resolve any delays or discrepancies.</li><li>Maintain up-to-date provider contracts, credentialing records, and licensing.</li></ul>Compliance &amp; Reporting:<ul><li>Stay updated on billing and credentialing regulations to ensure compliance.</li><li>Generate reports on billing and credentialing activities.</li><li>Assist with internal audits to ensure adherence to best practices and regulations.</li></ul>Collaboration:<ul><li>Coordinate with healthcare providers to gather necessary documentation for billing and credentialing.</li><li>Collaborate with insurance companies to resolve claims and credentialing issues.</li><li>Work with finance and administrative teams to improve the revenue cycle.</li></ul>Qualifications:<ul><li>High school diploma or equivalent required; Associate&rsquo;s or Bachelor&rsquo;s degree in healthcare administration, business, or related field preferred.</li><li>Proficiency in the English language</li></ul>Experience:<ul><li>2+ years of experience in medical billing, coding, and credentialing.</li><li>Strong knowledge of billing practices, insurance regulations, and credentialing procedures.</li><li>Experience with medical billing software and EHR systems (e.g., Epic, Kareo, AdvancedMD).</li></ul>Skills:<ul><li>Knowledge of CPT, ICD-10, and HCPCS coding standards.</li><li>Familiarity with Medicare, Medicaid, and commercial insurance billing processes.</li><li>Strong organizational skills and attention to detail.</li><li>Excellent communication and interpersonal skills.</li><li>Ability to work independently and as part of a team.</li><li>Proficiency in Microsoft Office Suite (Excel, Word).</li></ul>Job Type: Full-timeWork Location: In person

Medical Billing and Credentialing Specialist

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