provider enrollment specialist

Top Line Resource Group (TLRG)

<p>Location: DHA phase 8, Lahore (Onsite)<br/>Work Schedule: 05PM &ndash; 02AM Pakistan Time<br/>Employment Type: Full-time (Night Shift)</p><p>Topline Resource Group (TLRG) is looking for a knowledgeable Credentialing and Enrollment Specialist to support the provider onboarding process and maintain payer credentialing records. This role focuses on ensuring healthcare providers are successfully enrolled with insurance carriers and that all credentialing documentation remains current and compliant with industry standards.</p><p>The successful candidate will play an important role in coordinating credentialing activities, maintaining provider records, and communicating with payers to ensure smooth enrollment and approval processes.</p><p><b>Core Responsibilities</b></p><ul><li>Handle the enrollment process for healthcare providers with insurance payers including Commercial plans, Medicare, Medicaid, and other specialty networks.</li><li>Maintain comprehensive credentialing documentation, ensuring records such as licenses, certifications, DEA registration, NPI information, and CAQH profiles remain accurate and updated.</li><li>Prepare and submit credentialing applications for new provider enrollment, renewals, and information updates with insurance carriers.</li><li>Monitor the progress of submitted applications and follow up with payers to facilitate timely processing and approvals.</li><li>Ensure all credentialing procedures comply with industry standards and payer policies, including NCQA and URAC requirements.</li><li>Review and validate provider documentation to confirm all credentialing criteria and regulatory standards are met.</li><li>Collaborate with internal departments such as Human Resources, Compliance, and Billing to support provider onboarding and credentialing updates.</li><li>Address credentialing discrepancies, assist with payer inquiries, and resolve enrollment-related issues when they arise.</li><li>Maintain organized records and generate reports related to provider enrollment and credentialing activities.</li></ul><p><b>Required Experience &amp; Qualifications</b></p><ul><li>Minimum 2&ndash;3 years of professional experience in provider enrollment and credentialing within the healthcare industry.</li><li>Strong understanding of U.S. healthcare insurance systems and credentialing workflows.</li><li>Working knowledge of credentialing standards including NCQA, URAC, and payer regulations.</li><li>Experience using credentialing platforms and EHR/Practice Management systems.</li><li>Strong organizational skills with the ability to manage multiple assignments efficiently.</li><li>Excellent written and verbal communication abilities.</li><li>High level of accuracy and attention to detail.</li></ul><p><b>Preferred Qualifications</b></p><ul><li>Experience handling provider enrollment across multiple U.S. states.</li><li>Ability to work independently in a fast-paced, high-volume environment while meeting deadlines.</li><li>Background in Revenue Cycle Management (RCM), medical billing, or healthcare administration is a plus.</li></ul><p>Pay: Rs80,000.00 - Rs110,000.00 per month</p><p>Experience:</p><ul><li>enrollment and credentialing: 2 years (Preferred)</li></ul><p>Work Location: In person</p>

Credentialing and Enrollment Executive - (US Healthcare)

HBSS ACADEMY

<p><b>Credentialing Specialist</b></p><p><b>Experience-</b> 3 to 4 years Proven</p><p><b>location-</b> J Block, LDA Avenue One Lahore</p><p><b>Salary: </b>100K to 120K</p><p><b>Timing- US EST</b>- 6 pm to 3 am in summer and 7 pm to 4 am in winter</p><p><b>Roles and Responsibilities</b></p><ul><li>Initiate enrollment with insurance companies for all new providers</li><li>Maintain the timelines on enrollment schedules, communicate with billing and the office managers on updates as needed and explain payer information requirements</li><li>Work closely with physicians and office mangers to obtain missing documentation on providers for enrollment with insurance companies</li><li>Follow-up with insurance companies for provider participation status</li><li>Complete re-credentialing for existing providers</li><li>Able to effectively communicate with team members, billing staff and insurance companies</li><li>Retain detailed and accurate lists of insurances for which clients participate</li><li>Performs other related duties, which may be inclusive, but not listed in the job description</li><li>Complete provider credentialing/contract applications with third-party carriers and government health plans.</li><li>Review provider credentialing and contracting information to ensure completeness and accuracy.</li><li>Monitor applications and follow-up in a timely manner.</li><li>Document, maintain and crosscheck client credentials in multiple databases, including CAQH and other third-party databases, as applicable.</li><li>Create, update and track provider information in the internal credentialing system to ensure that credentials are completed timely and correctly.</li><li>Meet or exceed required timeframes for provider communications, enrollments, and follow-ups.</li><li>Maintain quality working relationships with internal and external customers.</li><li>Collect, Submit, &amp; Track all necessary documentation.</li><li>Process re-credentialing for existing clinicians as required by individual payers.</li><li>Maintain a current, accurate database of all clinicians&rsquo; credentialing / licensure status, needs, expirations, issues, etc. Share with internal staff as applicable.</li><li>Communicate &amp; Coordinate with all levels of internal staff &amp; external stakeholders to ensure timely &amp; consistent qualification is met &amp; maintained.</li><li>Monitor expiring credentials to ensure ongoing compliance with regulatory guidelines.</li><li>Investigate and resolve any issues that arise during the approval process.</li><li>Under the direction of leadership, assist with site level enrollments or changes to contract.</li><li>Other duties as deemed necessary.</li></ul><p><b>Contact HR.</b></p><p>hr@thequestmbs.com 03324641025</p><p>Pay: Rs100,000.00 - Rs120,000.00 per hour</p><p>Expected hours: 45.0 per week</p><p>Work Location: In person</p>

Credentialing Specialist

Macrise Tech Solutions

<p>The <b>Credentialing Specialist</b> is responsible for overseeing the full lifecycle of provider credentialing and re-credentialing across multiple insurance networks, payers, and credentialing platforms. This role requires a proactive and detail-oriented individual with strong follow-up skills to ensure continuous compliance with regulatory standards, uninterrupted provider participation, and smooth billing and authorization processes. The position plays a vital role in maintaining operational efficiency and supporting accurate and timely reimbursements.</p><p><b>Key ResponsibilitiesCredentialing &amp; Compliance</b></p><ul><li>Maintain, organize, and routinely update provider credentialing records for both commercial and government payers.</li><li>Manage and monitor CAQH profiles to ensure alignment with CMS regulations and payer-specific credentialing requirements.</li><li>Process initial credentialing, re-credentialing, and payer enrollment applications for Medicare, Medicaid, and commercial insurance networks.</li><li>Handle applications, renewals, and documentation related to professional licenses, DEA registrations, and controlled substance certifications.</li><li>Complete provider revalidation processes with government and regulatory agencies within defined timelines.</li><li>Coordinate hospital credentialing activities, including managing provider privileges and maintaining active affiliations.</li></ul><p><b>Collaboration &amp; Operational Support</b></p><ul><li>Partner with the Revenue Cycle Director and Billing Team to resolve credentialing-related denials, payer issues, and authorization delays.</li><li>Ensure accuracy and consistency of provider information across CAQH, PECOS, NPPES, CMS databases, and internal systems.</li><li>Maintain a centralized credentialing tracker, including provider credentials, expiration dates, payer participation status, and system access details.</li><li>Provide administrative support for credentialing audits, compliance reviews, and regulatory documentation as needed</li></ul><p>Job Type: Full-time</p><p>Pay: Rs45,000.00 - Rs80,000.00 per month</p><p>Ability to commute/relocate:</p><ul><li>Wapda Town: Reliably commute or planning to relocate before starting work (Required)</li></ul><p>Application Question(s):</p><ul><li>Willing to work the night shift in Wapda Town, Lahore?</li></ul><p>Experience:</p><ul><li>Credentialing: 1 year (Required)</li></ul><p>Language:</p><ul><li>English (Required)</li></ul><p>Work Location: In person</p>

Credentialing & Provider Enrollments Executive-Medical Billing

sequel technologies

<p><b>Location:</b> Bahria Town Phase 7, Rawalpindi (Preference for residents of Bahria, DHA, or nearby areas)</p><p><b>Company Description</b><br/>Sequel Technologies, a software company providing healthcare IT and medical billing services to the US market.</p><p><b>Responsibilities</b></p><ul><li>Manage end-to-end provider enrollment and credentialing with commercial and government payers (Medicare, Medicaid)</li><li>Prepare, review, and submit enrollment applications and supporting documentation accurately and on time.</li><li>Track application status, follow up with payers, and resolve rejections or delays.</li><li>Maintain and update provider data across EHR, billing, and credentialing systems.</li><li>Handle EDI, ERA, and EFT enrollments with payers and clearinghouses.</li><li>Collaborate with billing and RCM teams to resolve claim denials related to enrollment issues.</li><li>Ensure compliance with payer requirements and regulatory standards (e.g., CMS, HIPAA).</li><li>Maintain credentialing databases (e.g., CAQH, PECOS, NPPES) and ensure provider records are current.</li><li>Support onboarding of new providers/clients by aligning enrollment with system setup.</li><li>Generate and maintain reports on enrollment status, timelines, and issues.</li><li>Perform audits to ensure data accuracy and completeness</li></ul><p><b>Qualifications/Skills</b></p><ul><li>Bachelor&rsquo;s degree in Healthcare Administration, Business, or related field (or equivalent experience)</li><li>2+ years of experience in provider enrollment, credentialing, or medical billing/RCM</li><li>Strong understanding of payer enrollment processes and insurance requirements</li><li>Experience with EHR/EMR systems and medical billing platforms</li><li>Familiarity with CAQH, PECOS, NPPES, clearinghouses, and payer portals</li><li>Knowledge of EDI, ERA, EFT, and claims workflows</li><li>High attention to detail and accuracy in handling documentation and data</li><li>Strong organizational and time management skills with ability to manage multiple enrollments</li><li>Excellent communication skills for working with providers, payers, and internal teams</li><li>Problem-solving ability to address enrollment and reimbursement issues</li><li>Proficiency in Microsoft Excel and reporting tools</li></ul><p><b>Timings</b></p><ul><li>5:00 PM &ndash; 2:00 AM (Summers)</li><li>6:00 PM - 3:00 AM (Winters)</li></ul><p><b>Benefits</b></p><ul><li>Healthcare (OPD + IPD)</li><li>Entertainment Allowance</li><li>Cellular Allowance</li><li>Provident Fund</li></ul><p>Job Type: Full-time</p><p>Application Question(s):</p><ul><li>Are you a resident of Bahria Town Phase 7/8, or DHA 1/2? If not, kindly state your area of residency.</li></ul><p>Work Location: In person</p>

Enrollment Specialist

Med-Metrix

Job Purpose
<br>The Provider Enrollment Associate is responsible for credentialing/enrolling new and established health care providers and maintenance of required information.
<br><br>
Duties and Responsibilities
<br><ul>
<li>Communicates with providers to explain process and sign applications</li>
<li>Collects, updates, maintains necessary provider information and documentation and verifies the information where possible</li>
<li>Establishes and maintains data entry in CAQH</li>
<li>Prepares provider enrollment applications for all initial applications and re-credentialing in a timely and complete manner</li>
<li>Verifies provider and group information with insurance companies (addresses, contracted plans, provider ID numbers, etc.)</li>
<li>Coordinates information for enrollment and termination of all providers</li>
<li>Handles enrollment with Medicare, Medicaid, commercial insurances</li>
<li>Contributes to the departmental process and procedures with a collaborative approach</li>
<li>Works department client WQ’s and smart feeds where applicable</li>
<li>Maintains provider enrollment mailbox and completes actions and follow up</li>
<li>Performs other duties as requested</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties</li>
</ul>
Qualifications
<br><ul>
<li>High School graduate or equivalent required</li>
<li>Minimum two years of provider enrollment experience</li>
<li>Knowledge of Microsoft Office Suite, Outlook, Excel, CAQH</li>
<li>Billing knowledge and experience preferred</li>
<li>Excellent verbal and written communication skills</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
<li>Gracious and welcoming personality for customer service interaction</li>
</ul>
Working Conditions
<br><ul>
<li>Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes.</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Provider Enrollment Associate- Remote

Mohawk Valley Health System

<div><div><div><h2 class="jobSectionHeader"><b>Job Summary</b></h2></div><div><p>
The Lead Payer Enrollment Coordinator coordinates provider credentialing and payer enrollment activities to ensure timely and accurate enrollment with contracted insurance carriers. This role assigns and monitors team workload, supports issue resolution, and collaborates with recruitment, medical staff, RCM, and operational leaders to prevent revenue disruption. The Coordinator ensures compliance with payer requirements, maintains accurate provider data in MDStaff and EPIC, and supports continuous improvement within the Provider Enrollment Department.
</p></div></div><div><div><h2 class="jobSectionHeader"><b>Core Job Responsibilities</b></h2></div><div><ul><li>
Coordinate and assign all new provider enrollments and provider changes to the Credentialing Team, ensuring balanced workload distribution and timely completion.</li><li>
Mentors and supports onboarding of new credentialing staff and junior staff; provides training and guidance on best practices.</li><li>
Serve as primary escalation point for complex provider and payer enrollment issues; communicate trends and barriers to the Provider Enrollment Manager.</li><li>
Collaborate with provider recruitment, medical staff, RCM, contracting, and operational leadership to support onboarding, facility enrollments, and prevent revenue delays.</li><li>
Monitor provider enrollment status across all carriers, ensuring accurate updates and documentation templates in MDStaff, enrollment tables in EPIC, and internal tracking tools.</li><li>
Communicates, at least monthly, with health plans (more if needed) to obtain statuses of providers and to address any claims issues including holds and denials.</li><li>
Ensure timely submission of new provider enrollments, facility applications, revalidations, terminations, roster updates, panel changes, and collaborating physician documentation.</li><li>
Lead enrollment activities for specialty programs including Residency NPIs and taxonomy updates, and physician extender requirements.</li><li>
Generate and distribute enrollment status reports and analyze denial trends to proactively address payer issues.</li><li>
Maintain working knowledge of payer policies, regulatory requirements, and credentialing platforms including CAQH, PECOS, and NPPES.</li><li>
Support process improvement initiatives and assist in development of departmental policies and procedures.</li><li>
Attend recruitment and payer meetings as required.</li><li>
Perform other duties as assigned.</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Education/Experience Requirements</b></h2></div><div><p><b>
REQUIRED:</b></p><ul><li>
High School Diploma or equivalent</li><li>
5 years of healthcare provider credentialing/enrollment experience.</li><li>
Experience with CAQH, NPPES, PECOS, and credentialing platforms.</li><li>
Working knowledge of revenue cycle operations and payer enrollment structure.</li><li>
Strong organizational, analytical, and problem-solving skills.</li><li>
Excellent written and verbal communication abilities.</li><li>
Proficiency in Microsoft Excel and credentialing systems.</li><li>
Ability to manage multiple priorities in a fast-paced, team-oriented environment.</li><li>
Commitment to confidentiality and data accuracy.</li></ul></div></div><div><div><h2 class="jobSectionHeader"><b>
Licensure/Certification Requirements</b></h2></div></div><div></div><div><div><h2 class="jobSectionHeader"><b>
Disclaimer</b></h2></div><div><p>
Qualified applicants will receive consideration for employment without regard to their age, race, religion, national origin, ethnicity, age, gender (including pregnancy, childbirth, et al), sexual orientation, gender identity or expression, protected veteran status, or disability.<br>
Successful candidates might be required to undergo a background verification with an external vendor.</p></div></div><div><div><h2 class="jobSectionHeader"><b>
Job Details</b></h2></div><div><p>
Req Id 97544<br>
Department REVENUE CYCLE<br>
Shift Days<br>
Shift Hours Worked 8.00<br>
FTE 1<br>
Work Schedule HRLY NON-UNION-8 HR<br>
Employee Status A1 - Full-Time<br>
Union Non-Union<br>
Pay Range $22.69 - $34.43/Hourly</p></div></div></div>

Lead Payer Enrollment Coordinator - Full Time - Days

Acron Aviation

<div><p><b>Please note: This is an on-site position that requires the selected candidate to work from our Sanford, FL, office. This is not a remote role.</b></p><p><b>
About Acron Aviation:</b></p><p>
Acron Aviation is an agile commercial aviation partner with a long heritage of delivering established, industry-certified solutions and future-focused, data-driven innovations. With customers worldwide, our employees are committed to the company's mission to innovate and create safer skies. For more information, visit acronaviation.com.</p><p><b>
Job Description:</b></p><p>
This role supports Academy Sales across multiple functions to drive increased student enrollment while serving as a key resource for prospective and newly enrolled students navigating private student loan funding (primarily Sallie Mae and Stratus). It also bridges Student Finance and Academy Sales by helping students understand the loan application process and funding timelines, while ensuring timely follow-up and accurate handoff to Student Finance for certification and decision-making. In addition, this role is responsible for selling and supporting Jet Transition and ATP/CTP.</p><p><b>
Essential Functions:</b></p><p><b>
Student Advising &amp; Communication</b></p><ul><li>
Serve as a primary point of contact for prospective and incoming students, providing timely updates and guidance throughout the enrollment journey</li><li>
Maintain proactive communication to help applicants stay on track for training start dates</li><li>
Deliver high-quality customer service and route complex concerns to the appropriate teams</li></ul><p><b>
Application &amp; Funding Guidance</b></p><ul><li>
Provide high-level guidance on private loan application processes, timelines, and common funding questions</li><li>
Monitor application progress through internal systems and lender portals to keep students informed of next steps</li><li>
Escalate complex financial or eligibility questions to Student Finance</li></ul><p><b>
Cross-Department Coordination</b></p><ul><li>
Partner with Admissions, Student Finance, Training, and Customer Relations to support a smooth onboarding experience</li><li>
Coordinate ATP/CTP and Jet Transition student support, including collaboration with BMA and internal teams</li><li>
Help resolve student concerns by working collaboratively across departments</li></ul><p><b>
 Student Experience &amp; Operational Support</b></p><ul><li>
Support campus and outreach events that help students learn about training opportunities</li><li>
Maintain accurate student information across internal systems</li><li>
Serve as a liaison across campus locations as needed</li></ul><p><b>
Education &amp; Experience</b></p><ul><li>
High school diploma or equivalent with 4+ years of relevant experience, or an associate degree with 2&ndash;4 years of related experience</li><li>
Experience in a customer-facing, student-facing, or operations-focused role</li><li>
Experience working in fast-paced environments with multiple priorities and deadlines</li></ul><p><b>
Communication &amp; Customer Support Skills</b></p><ul><li>
Strong written and verbal communication skills with the ability to support customers and collaborate across internal teams</li><li>
Ability to confidently navigate sensitive or challenging conversations and assist with early de-escalation</li><li>
Responsive and professional across multiple communication platforms (phone, email, chat, and internal systems)</li></ul><p><b>
Organization &amp; Problem Solving</b></p><ul><li>
Highly organized with strong attention to detail and the ability to manage multiple tasks simultaneously</li><li>
Proactive mindset with the ability to anticipate needs and identify solutions before issues escalate</li><li>
Demonstrated ownership and accountability when handling questions, concerns, and follow-up items</li></ul><p></p><p><b><br>
Technical &amp; Operational Skills</b></p><ul><li>
Proficiency with Microsoft Office, including intermediate Excel skills and Microsoft Teams</li><li>
Experience working with multiple systems and maintaining accurate records</li><li>
Basic understanding of accounting concepts or accounts receivable processes</li></ul><p><b>
Industry &amp; Systems Experience</b></p><ul><li>
Experience in higher education, vocational training, aviation, sales, or similar service-based environments</li><li>
Familiarity with private student loan processes (e.g., Sallie Mae)</li><li>
Experience using CRM or student information systems</li><li>
Ability to quickly learn new software tools used for operations, compliance, and student support</li></ul></div><p></p>

Enrollment Support Specialist

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