Credentialing Specialist – US Medical Billing job in Lahore Full Time NEW

We are seeking a detail-oriented and experienced Credentialing  Specialist to join our US 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

• Manage the credentialing and enrollment process for healthcare providers with insurance networks, Medicare, Medicaid, and other relevant programs.
• Prepare and submit credentialing, re-credentialing, and revalidation documents accurately and promptly.
• Ensure compliance with all credentialing requirements, regulations, and standards set by accrediting bodies and government agencies.
• Communicate with insurance companies, providers, and internal stakeholders to resolve credentialing issues and inquiries.
• Maintain up-to-date knowledge of current healthcare regulations, policies, and procedures related to credentialing and enrollment.
• Coordinate with internal departments to gather necessary documents and information for credentialing applications.
• Monitor application status, track expirations, and follow up on pending items to ensure timely completion.
• Maintain accurate and organized credentialing and enrollment records, both electronic and paper-based.
• Assist with audits and reviews of credentialing and enrollment processes.

Requirements

• Graduation is mandatory
• Minimum of 2-3 years of experience in healthcare credentialing and enrollment, preferably in a medical billing setting.
• In-depth knowledge of credentialing processes for insurance networks, Medicare, Medicaid, and other payers.
• Familiarity with CAQH, NPI, UPIN, and other relevant healthcare databases and identifiers.
• Strong understanding of healthcare regulations, compliance standards, and HIPAA guidelines.
• Excellent English communication skills, both verbal and written, with the ability to interact professionally with providers and insurance representatives.
• Exceptional attention to detail, accuracy, and organizational skills.
• Proficiency in using MS Office applications and credentialing software.
• Ability to work independently, prioritize tasks, and meet deadlines in a fast-paced environment.

  Position: Credentialing Specialist – US Medical Billing

  Location: Johar Town, Lahore (100% onsite)

  Timings: 5 PM-2 AM