Senior Credentialing Specialist

5 days ago


Islamabad, Islamabad, Pakistan Pyramids Global (Pvt) Ltd. Full time
Overview

Pyramids Global (Pvt) Ltd. is a leading healthcare solutions provider, specializing in Revenue Cycle Management (RCM), medical billing, credentialing, and patient support services.

We are dedicated to delivering seamless and compliant healthcare solutions to providers across the U.S.

About the Position:

We are looking for an experienced Senior Credentialing Specialist to join our team.

The successful candidate will have a proven track record in medical credentialing, privileging, and compliance management.

Key Responsibilities:

  1. Lead and mentor the credentialing team, ensuring accuracy and compliance in all processes.
  2. Oversee credentialing, privileging, and licensing workflows to maintain provider eligibility.
  3. Ensure compliance with regulatory and accrediting institutions.
  4. Implement and refine internal credentialing processes to improve efficiency and compliance.
  5. Maintain up-to-date records of provider licenses, credentials, and insurance contracts.
  6. Act as the point of contact for regulatory agencies, insurance providers, and healthcare partners.
  7. Train and develop team members to enhance performance and adherence to best practices.
  8. Provide detailed reports on credentialing statuses, expirations, and compliance metrics.

Required Skills and Qualifications:

  • Bachelor's degree (HEC recognized) – A CPCS certification is a plus.
  • 3+ years of experience in medical credentialing, privileging, and compliance management.
  • Proven leadership skills with experience managing and mentoring teams.
  • Strong understanding of healthcare regulations, payer enrollment, and credentialing workflows.
  • Proficiency in EMR systems, credentialing databases, and Microsoft Office (Excel & Word).
  • Exceptional organizational and communication skills with a strong attention to detail.


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