Senior Credentialing Specialist (Payor & Facility Credentialing) - REMOTE

Alina Telehealth; Karachi Division; Remote; PKR 11,293,000 - 15,528,000; Full time

Job summary

A leading healthcare organization in Karachi is seeking a Senior Credentialing Specialist to manage provider credentialing and ensure compliance with regulatory standards. The ideal candidate will have at least 2 years of relevant experience, strong English communication skills, and expertise in payor enrollment processes. This high-impact role requires strong attention to detail and the ability to thrive in a fast-paced environment.

Qualifications

• Minimum 2 years of experience in payor credentialing and facility credentialing required.
• Strong command of credentialing workflows and regulatory requirements.
• Exceptional attention to detail and organizational skills.

Responsibilities

• Manage the full credentialing and re-credentialing workflow for physicians.
• Complete and track payor enrollment applications.
• Coordinate facility privileging and maintain compliance.

Skills

Credentialing workflows

Payor enrollment processes

Attention to detail

Multitasking

Fluent English communication

Tools

CAQH

PECOS

NPPES

Availity

Job description

Job Description

The Senior Credentialing Specialist will oversee and execute all aspects of provider credentialing, re-credentialing, payor enrollment, and facility privileging. You will work closely with internal teams, hospitals, insurance payors, and regulatory bodies to ensure seamless onboarding and compliance for our physician network.

This is a high-impact role for someone who thrives in a fast‑paced environment and is ready to take ownership of the entire credentialing lifecycle.

Responsibilities

1. Manage the full credentialing and re-credentialing workflow for physicians and advanced practitioners
2. Complete and track payor enrollment applications (Medicare, Medicaid, commercial payors, CAQH, PECOS, NPPES)
3. Coordinate facility privileging and ensure compliance with Joint Commission, NCQA, and state-specific regulations
4. Maintain accurate and up-to-date provider files, licenses, certifications, and credentialing databases
5. Verify education, training, board certifications, malpractice history, and NPDB reports
6. Ensure timely submission of applications and respond promptly to requests for corrections or additional information
7. Monitor expirables (licenses, DEA, CDS, malpractice) and proactively manage renewals
8. Collaborate with internal operations, medical staff offices, and provider relations teams
9. Implement best practices to reduce turnaround times and increase credentialing efficiency
10. Maintain compliance with federal, state, and accreditation standards

Job Specification

Minimum 2 years of experience in payor credentialing and facility credentialing (required)

Strong command of credentialing workflows, payor enrollment processes, and privileging protocols

Fluent, native-level English communication skills (spoken & written)

Experience with CAQH, PECOS, NPPES, Availity, and other enrollment portals

Strong understanding of NCQA, CMS, TJC standards, and regulatory requirements

Exceptional attention to detail and organizational skills

Ability to multitask in a fast‑paced, deadline-driven environment