Credentialing Specialist

Prima Systems Pakistan is seeking a full-time Credentialing Specialist to join their team in Johar Town, Lahore. This on-site position operates on a night shift schedule from Monday to Friday, 6:00 PM to 3:00 AM. The ideal candidate will have 1 to 2 years of experience in the healthcare industry, specifically in medical staff credentialing. This role involves managing the entire credentialing process for healthcare providers, ensuring all documentation is accurate and up to date, and coordinating with various stakeholders such as medical staff, insurance companies, and regulatory bodies.

Key Responsibilities:
The Credentialing Specialist will be responsible for overseeing the end-to-end credentialing process, including collecting, verifying, and maintaining provider information and documentation. The role requires coordination with medical staff, insurance companies, and regulatory agencies to facilitate timely credentialing, re-credentialing, and enrollment, particularly with Medicare and other payers. Daily tasks include reviewing applications, tracking credentialing statuses, resolving discrepancies, responding to inquiries from providers and clients, and ensuring compliance with relevant standards and company policies. The specialist will collaborate closely with internal teams to support smooth provider onboarding, maintain accurate records, and contribute to efficient revenue cycle management.

Required Qualifications:
- A bachelor’s degree in any field is required, with preference given to candidates holding degrees in healthcare administration, business, or related disciplines.
- At least one year of experience in medical staff credentialing, including managing provider enrollment and verification processes.
- Familiarity with credentialing platforms such as CAQH, PECOS, NPI, and various insurance portals.
- Strong communication skills, both written and verbal, to effectively interact with providers, payers, and internal teams.
- Excellent customer service skills, demonstrating professionalism, responsiveness, and the ability to build positive relationships.
- Working knowledge of Medicare requirements and payer-specific credentialing rules.
- Attention to detail, strong organizational and time management abilities, and proficiency with credentialing or practice management software.

Preferred Qualifications and Benefits:
Experience within healthcare BPO operations is considered an advantage for this role. The position offers the opportunity to work in a dynamic healthcare environment with a focus on professional growth and development. Being part of Prima Systems Pakistan means contributing to a team that values accuracy, compliance, and efficient healthcare provider management.

This role is ideal for candidates seeking to advance their career in healthcare credentialing while working in a structured, supportive on-site setting during night hours.