Credentialing Specialist

We are looking for a detail-oriented Credentialing Specialist to manage provider onboarding processes with U.S. insurance carriers. This role acts as the primary liaison between healthcare providers and insurance networks, ensuring accurate directory synchronization and smooth claim reimbursement cycles. The position requires working on-site in Rawalpindi during night shifts from 5:30 PM to 2:30 AM, Monday through Friday.

Key Responsibilities
- Resolve complex issues related to credentialing rejections, application delays, and network enrollment challenges.
- Maintain daily communication with commercial and government U.S. insurance payers to expedite provider participation approvals.
- Ensure provider directory information is consistently updated across all payer portals, CAQH profiles, and internal systems to avoid claim denials.
- Monitor and track credential expirations, including state licenses, DEA certificates, and malpractice insurance coverage.
- Collaborate closely with internal medical billing and accounts receivable teams to resolve network-related claim holds and billing blocks.

Required Qualifications
- Bachelor’s degree in Healthcare Management, Business Administration, or a related field.
- 3 to 5 years of experience specializing in U.S. medical credentialing or provider enrollment.
- Strong knowledge of U.S. healthcare billing systems, Medicare/Medicaid enrollment processes, and commercial payer guidelines.
- Excellent phone etiquette, attention to detail, and strong analytical problem-solving skills.
- Willingness and ability to work on-site during the specified night shift hours in Rawalpindi.

Preferred Qualifications and Benefits
- Fixed weekends off (Saturday and Sunday).
- Competitive base salary with additional financial incentives such as yearly loyalty rewards, inflation bonuses, HR performance bonuses, and regular salary reviews.
- Access to loan policies, advance salary options, and participation in the Employee Equity Funds Program (EEFP).
- Paid leaves, leave encashment, and medical benefits.
- Office amenities include complimentary nightly dinner and two daily tea/green tea breaks.

Candidates should be able to commute easily to the office located on Murree Road, Rawalpindi, and be comfortable working the night shift. During the application process, candidates will be asked about their current salary, notice period, experience, and salary expectations. This is an in-person role requiring full-time commitment.