Sr Credentialling Expert

We are looking for a Senior Credentialing Expert to join our team on a full-time, on-site basis in Rawalpindi. This role requires working the night shift from 5:30 PM to 2:30 AM, Monday through Friday. The primary focus will be to facilitate the swift approval and activation of healthcare providers within U.S. insurance networks. As a vital liaison between our organization and insurance payers, you will ensure seamless network participation and help maintain strong payer relationships.

Key Responsibilities
- Manage external communications and expedite network participation pipelines with U.S. insurance carriers.
- Engage directly with insurance companies to resolve processing delays and accelerate provider active status approvals.
- Address and resolve complex credentialing issues, including bottlenecks, rejections, and discrepancies in network status with urgency.
- Conduct audits and reconcile provider directories across payer portals, CAQH, and internal databases to ensure accuracy.
- Collaborate closely with internal Revenue Cycle Management (RCM) and billing teams to resolve claims that are stalled due to credentialing challenges.

Required Qualifications
- Bachelor’s degree in Business Administration, Healthcare Management, or a related discipline.
- Between 3 to 5 years of specialized experience in U.S. provider credentialing or payer relations.
- Strong knowledge of U.S. healthcare credentialing standards and familiarity with both commercial and government payers.
- Excellent negotiation, tracking, and problem-solving abilities.
- Willingness and ability to work the designated night shift hours (5:30 PM to 2:30 AM).

Additional Information
The position is based at our office in Rawalpindi, located at Asghar Mall, Murree Road. Candidates should be able to commute to this location regularly. Applicants are expected to be comfortable working night shifts as outlined. During the application process, candidates will be asked about their current and expected salary, total experience, and any notice period obligations.

This role offers an opportunity to work in a dynamic environment where your expertise in credentialing will directly impact provider network participation and revenue cycle efficiency. If you meet the qualifications and are ready to take on a challenging yet rewarding position, we encourage you to apply.