Credentialing Specialist

Transmute PVT LTD; Lahore; On-site; PKR 600,000 - 900,000; Full time

Job summary

Transmute PVT LTD in Lahore is seeking an experienced Credentialing Specialist to manage provider credentialing, payer enrollments, and maintain accurate provider records. The role emphasizes CAQH profile creation and ongoing updates, PECOS and NPPES tasks, and ensuring all enrollments meet payer requirements.

You will coordinate with internal teams, handle deadlines, and support revenue cycle activities within the US healthcare space, bringing strong attention to detail, excellent

Qualifications

• Experience in healthcare credentialing
• Knowledge of US payer enrollment processes
• Experience with Medicare, Medicaid, and commercial enrollments
• Excellent communication and follow-up skills
• Strong attention to detail and organizational abilities
• Ability to work independently and manage multiple deadlines

Responsibilities

• Manage provider credentialing and re-credentialing processes.
• Handle CAQH profile creation, updates, and maintenance.
• Process Medicare and Medicaid provider enrollments.
• Follow up with insurance companies regarding enrollment status.
• Perform PECOS and NPPES updates.
• Maintain accurate provider records and credentialing documentation.
• Ensure compliance with payer requirements and deadlines.
• Coordinate with internal teams and providers to resolve credentialing issues.

Skills

Healthcare credentialing

US payer enrollment processes

Medicare/Medicaid enrollments

Attention to detail

Organizational skills

Independent working

Deadline management

Communication

Tools

CAQH

PECOS

NPPES

Medicare enrollment portals

Job description

We are looking for an experienced Credentialing Specialist to join our growing healthcare team in Lahore. The ideal candidate should have hands-on experience with provider credentialing, payer enrollments, and maintaining accurate provider records.

Key Responsibilities

• Manage provider credentialing and re-credentialing processes.
• Handle CAQH profile creation, updates, and maintenance.
• Process Medicare and Medicaid provider enrollments.
• Follow up with insurance companies regarding enrollment status.
• Perform PECOS and NPPES updates.
• Maintain accurate provider records and credentialing documentation.
• Ensure compliance with payer requirements and deadlines.
• Coordinate with internal teams and providers to resolve credentialing issues.

Requirements

• Previous experience in healthcare credentialing.
• Strong knowledge of US healthcare payer enrollment processes.
• Experience with Medicare, Medicaid, and commercial insurance enrollments.
• Excellent communication and follow-up skills.
• Strong attention to detail and organizational abilities.
• Ability to work independently and manage multiple deadlines.

Why Join Us?

• Opportunity to grow within the US healthcare industry.
• Work with an experienced healthcare operations team.
• Professional and collaborative work environment.
• Exposure to advanced credentialing and revenue cycle processes.