Credentialing Specialist

13 hours ago


Lahore, Punjab, Pakistan PCS Pakistan Full time

Job Title: Credentialing Specialist - Medical Billing

We are seeking a skilled Credentialing Specialist to join our team at Practice Care Solutions Pakistan. As a Credentialing Specialist, you will be responsible for overseeing the credentialing process for all healthcare providers, ensuring timely submissions to insurance companies and health plans.

Responsibilities:

  • Oversee the credentialing process for all healthcare providers, ensuring timely submissions to insurance companies and health plans.
  • Prepare, submit, and track credentialing applications for initial and re-credentialing processes.
  • Maintain and update provider files to ensure compliance with state, federal, and payer requirements.
  • Work closely with providers to gather necessary documentation for credentialing and licensure verification.
  • Liaise with insurance carriers to resolve credentialing issues and ensure proper network participation.
  • Manage credentialing updates and renewals to avoid disruptions in provider participation.

Qualifications:

  1. Associate's or bachelor's degree in healthcare administration, business, or a related field is preferred.
  2. At least 2 years of experience in credentialing healthcare providers with health plans and insurance carriers.
  3. Strong understanding of credentialing processes and payer requirements.
  4. Excellent communication and organizational skills.


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