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medical billing and coding specialist

HRMD Solutions

Location: Gulberg 3, Lahore Shift: Night (Full-time, On-site Only) Salary: Rs. 70,000 &ndash; Rs. 100,000/monthIMPORTANT: Please read before applying&#9989; ONLY candidates with prior experience in Prior Authorization or Medical Billing will be considered.&#10060; Applicants without relevant healthcare experience (e.g., teaching, engineering, IT, sales, etc.) will be automatically rejected.About the Role:We are urgently hiring a Prior Authorization Specialist to join our growing medical billing team focused on pain management. The ideal candidate must have hands-on experience in obtaining insurance authorizations for medical procedures and medications.Key Responsibilities:<ul><li>Obtain and manage prior authorizations for pain management treatments (injections, surgeries, etc.)</li><li>Review and validate patient records to ensure accurate and complete documentation</li><li>Coordinate with insurance companies, providers, and patients to facilitate approvals</li><li>Handle appeals for denied authorizations when necessary</li><li>Track authorization status and follow up regularly to avoid delays</li><li>Collaborate with the clinical team to meet billing and documentation standards</li></ul>Requirements:<ul><li>Minimum 6 months of relevant experience in Prior Authorization or Medical Billing</li><li>Knowledge of pain management treatments is a plus</li><li>Strong understanding of medical coding, terminology, and insurance guidelines</li><li>Familiarity with EHR systems and RCM processes</li><li>Excellent communication and follow-up skills</li></ul>Job Type: Full-timePay: Rs70,000.00 - Rs100,000.00 per monthApplication Question(s):<ul><li>Do you live in lahore?</li><li>Can you work night shift (on site)?</li></ul>Work Location: In person

Prior Authorization Specialist – Medical Billing (Night Shift | On-site Only)

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

Prima Systems

Job Title: Medical Record SpecialistLocation: 100% onsite Lahore Timings: Night Shift 5PM-2AMQualification: Bachelors Degree is mandatory Experience: 2-3 years in Medical Record Job Summary:The Medical Record Specialist is responsible for managing and executing medical record requests from various sources. This role involves identifying the specific records required for different types of requests, retrieving accurate and complete documentation from the Electronic Medical Record (EMR) system, coordinating with internal staff to ensure completeness, and assisting in the development and improvement of medical record request processes. The Specialist serves as a critical liaison between the medical records team and clinical staff to ensure timely, accurate, and compliant delivery of records.Key Responsibilities:<ul><li>Medical Records Request Processing:</li><li>Receive and review incoming medical record requests to determine the scope and specific records needed.</li><li>Identify and retrieve appropriate medical records from the EMR system based on the request type (e.g., legal requests, insurance, patient requests, research).</li><li>Ensure all requested documents are complete, accurate, and comply with privacy regulations (HIPAA).</li><li>Process Development &amp; Documentation:</li><li>Collaborate with management and team members to develop standardized processes and protocols for handling medical records requests.</li><li>Create detailed workflows outlining which records to pull for various request types and where to locate them in the EMR.</li><li>Maintain up-to-date documentation and tracking systems for all records requests.</li><li>Staff Coordination and Follow-up:</li><li>Liaise with clinical staff, billing departments, and other relevant personnel to obtain missing or incomplete records.</li><li>Track the status of requests and escalate delays or issues to management.</li><li>Provide training and guidance to staff on the importance of accurate and timely record-keeping for requests.</li><li>Quality Control and Compliance:</li><li>Review records for completeness and accuracy before submission.</li><li>Ensure adherence to all legal, regulatory, and institutional requirements related to medical record handling.</li><li>Support audit and compliance activities as needed.</li><li>Reporting and Communication:</li><li>Provide regular updates to management regarding request volumes, challenges, and process improvements.</li><li>Serve as a point of contact for inquiries related to medical record requests.</li></ul>Job Type: Full-timeWork Location: In person

Medical Record Specialist (US Medical Billing Industry)

IGarner System

Job Opportunity: Dental Billing Specialist Cyber System Medical Billing - Now Hiring Onsite!Location: Mozang, 03 Fane RoadAre you an experienced and meticulous Dental Billing Specialist with exceptional English communication skills? Join the dedicated team at Cyber System Medical Billing and help us ensure accurate and timely revenue cycles for our dental clients! This is a full-time, onsite position.The Role: Dental Billing SpecialistAs a Dental Billing Specialist, you will be crucial in managing the complete billing cycle for our US-based dental practices. Your primary focus will be on maximizing collections, minimizing claim denials, and ensuring compliance.Key Responsibilities:<ul><li>Claim Submission: Prepare, review, and submit dental claims (ADA codes) accurately and promptly to various insurance carriers (PPOs, HMOs, etc.).</li><li>A/R Follow-up: Aggressively follow up on outstanding claims, appeals, and denials via phone and online portals.</li><li>Payment Posting: Accurately post insurance and patient payments, adjustments, and denials.</li><li>Verification: Perform detailed insurance eligibility and benefits verification for scheduled procedures.</li><li>Communication: Liaise effectively with insurance company representatives and internal teams, often requiring complex explanation and negotiation.</li><li>Reporting: Generate reports on billing activities, collection rates, and denial trends.</li></ul>Required Qualifications:<ul><li>Prior Experience is a Must: Proven, verifiable experience as a Dental Billing Specialist or similar role in the healthcare/medical billing sector.</li><li>Exceptional English Speaking Skills: Mandatory requirement for clear, professional, and effective communication with US contacts.</li><li>Dental Coding Proficiency: Deep knowledge of coding, dental terminology, and standard dental billing practices.</li><li>Onsite Commitment: Must be available to work full-time, onsite at our Mozang, 03 Fane Road office.</li><li>Technical Skills: Proficient with dental practice management softwares</li><li>Detail-Oriented: Excellent organizational skills and attention to detail to ensure billing accuracy.</li></ul>Why Join Cyber System Medical Billing?<ul><li>Competitive salary package.</li><li>Stable, professional, and supportive work environment.</li><li>Opportunity to be part of a growing company in the revenue cycle management industry.</li></ul>Job Type: Full-timePay: Rs80,000.00 - Rs100,000.00 per monthWork Location: In person

Dental Billing Specialist

A Denials ere's Job Position Summary:The Denials Management Specialist is responsible for reviewing and resolving denied or rejected insurance claims to maximize reimbursement. This role involves analyzing denial trends, identifying root causes, and working with payers, internal departments, and appeals teams to prevent future denials and improve collection rates.Key Responsibilities:<ul><li>Review and analyze insurance claim denials and rejections.</li><li>Determine the root cause of denials and take corrective action.</li><li>Prepare and submit appeals with supporting documentation as needed.</li><li>Communicate with insurance companies to follow up on pending or denied claims.</li><li>Work collaboratively with billing, coding, and clinical teams to correct errors and resubmit claims.</li><li>Track and document denial trends, appeal success rates, and recovery efforts.</li><li>Stay current with payer policies, coding guidelines, and reimbursement procedures.</li><li>Recommend process improvements to reduce denial rates.</li><li>Meet or exceed productivity and accuracy standards.</li><li>Maintain confidentiality of patient and organization data.</li></ul>Qualifications:<ul><li>High school diploma or GED required; Associate&rsquo;s or Bachelor&rsquo;s degree preferred.</li><li>2+ years of experience in medical billing, coding, or denials management.</li><li>Strong knowledge of medical terminology, CPT, ICD-10, and HCPCS coding.</li><li>Familiarity with payer-specific denial codes and appeal processes.</li><li>Experience with billing software and Electronic Health Records (EHR) systems (e.g., Epic, Cerner, Athena).</li><li>Excellent communication and problem-solving skills.</li><li>Detail-oriented with strong organizational skills.</li></ul>Preferred Certifications:<ul><li>Certified Professional Coder (CPC)</li><li>Certified Revenue Cycle Specialist (CRCS)</li><li>Certified Medical Reimbursement Specialist (CMRS)</li></ul>Work Environment:<ul><li>Office-based or remote (depending on company policy)</li><li>May require extended periods of computer use</li><li>Fast-paced, deadline-driven</li></ul>Job Type: Full-timePay: Rs50,000.00 - Rs100,000.00 per monthWork Location: In person

Denial Management specialist

Healthrix

We are seeking a highly motivated and detail-oriented Accounts Receivable (AR) Specialist to join our medical billing team. The AR Executive will be responsible for managing accounts receivable functions, including billing, collections, and resolving outstanding claims. <ul><li>Process and submit medical claims to insurance companies, government agencies, and other third-party payers.</li><li>Communicate with insurance companies, patients, and healthcare providers to resolve billing issues and inquiries.</li><li>Investigate and resolve claim denials, rejections, and discrepancies promptly and work on Appeal Management.</li><li>Collaborate with other departments, such as coding and revenue cycle. management, to streamline billing processes and improve collections efficiency.</li><li>Must know healthcare regulations, insurance policies, and billing procedures.</li><li>Follow up on outstanding accounts receivable balances to ensure timely payment.</li><li>Identify and bill secondary or tertiary insurance.</li></ul>Requried Competencies:<ul><li>Strong written and verbal communication skills.</li><li>Proficiency in Microsoft Office Suite.</li><li>Proficiency in Microsoft Office Suite.</li><li>Excellent organizational skills.</li><li>At least 2 to 3 years of relevant experience.</li></ul>Job Location:<ul><li>Lahore</li><li>Willing to work in night shift </li></ul>Gender:<ul><li>Male / Female</li></ul>Job Type: Full-timePay: From Rs70,000.00 per monthWork Location: In person

Senior AR Executive

Physicians Revenue Group

Location: College Road, Lahore (Onsite) Shift: 06:00 PM &ndash; 03:00 AM PKT (US Time Zone)Company: Physcian Revenue Group Pakistan.Position: Revenue Cycle Management Specialist - Medical Billing - AR SpecialistAbout Us: Physician Revenue Group (PRG) is a leading US-based Revenue Cycle Management (RCM) company with offices in the United States and Pakistan. We provide end-to-end medical billing services to healthcare providers including physicians, clinics, and hospitals, ensuring accurate claims, faster reimbursements, and compliance with US healthcare regulations.Role Overview: We are looking for RCM Billing Executives to manage the end-to-end medical billing cycle for US healthcare providers. The role involves patient eligibility checks, claim creation &amp; submission, payment posting, denial management, AR follow-ups, and reporting. Candidates with strong knowledge of US healthcare billing, insurance guidelines, and RCM processes are encouraged to apply.Key Responsibilities:<ul><li>Manage the full Revenue Cycle Management (RCM) process</li><li>Patient Scheduling &amp; Eligibility Verification</li><li>Claim Creation, Charge Entry &amp; Submission (CMS-1500, UB-04)</li><li>Payment Posting, ERA &amp; EOB reconciliation</li><li>Denial Management &amp; Resubmission of claims</li><li>AR follow-ups with insurance companies &amp; patients</li><li>Patient Statements &amp; Reporting</li><li>Ensure compliance with HIPAA regulations and US healthcare billing standards.</li><li>Work with providers, payers, and patients to resolve billing issues.</li><li>Handle authorizations, referrals, and ABNs where required.</li><li>Apply correct CPT/ICD coding, POS codes, and Modifiers for accurate billing.</li></ul>Use medical billing software such as eCW, AdvancedMD, Tebra, NextGen, Epic, CareCloud, Practice Fusion, Office Ally.Required Skills &amp; Knowledge <ul><li>Strong understanding of US healthcare RCM: Scheduling, Eligibility, Claim Submission, Payment Posting, Denials, AR, Patient Billing, Reporting.</li><li>Knowledge of Medicare, Medicaid, Tricare, Commercial Insurances, Participating vs Non-Participating Providers, Capitation Models, and Authorization Types.</li><li>Familiarity with Modifiers, POS Codes, Common Abbreviations (NPI, TIN, HIPAA, CPT, ICD, EOB, ERA, etc.).</li><li>Exposure to multiple specialties such as Internal Medicine, Family Practice, Pediatrics, Cardiology, Orthopedics, Dermatology, OB/GYN, Psychiatry, Radiology, Neurology, Pulmonology, Endocrinology, and more. (Preferred)</li><li>Good English communication skills (verbal &amp; written).</li><li>Ability to work under deadlines in a fast-paced environment.</li></ul>Qualifications:<ul><li>Bachelor&rsquo;s degree (minimum requirement).</li><li>6 month &ndash; 2 years&rsquo; experience in US-based Medical Billing / RCM.</li></ul>Perks &amp; Benefits <ul><li>Competitive salary + Fuel Card / Allowances.</li><li>Career growth in the US healthcare billing industry.</li><li>Collaborative &amp; supportive work environment.</li><li>Health Insurance</li></ul>If you are passionate about building your career in Medical Billing (RCM) and want to work with a global team, we&rsquo;d love to hear from you.Job Type: Full-timeExperience:<ul><li>Denial Management: 1 year (Preferred)</li></ul>Work Location: In person

RCM - Billing Executive

Explore 3586+ Medical billing and coding specialist in Lahore this October. Find roles across top companies and apply now to boost your career.