Credentialing Specialist

About the role

SysMD, a healthcare financial solutions and Revenue Cycle Management company serving U.S. medical practices, is hiring a Credentialing Specialist in Lahore. The role manages provider enrollment, payer applications and record keeping so that medical and behavioral health providers get timely approvals.

Key responsibilities

• Manage credentialing and enrollment for medical and behavioral health providers across specialties
• Prepare and submit applications to Medicare, Medicaid and commercial insurers
• Maintain provider profiles, complete attestations and keep information accurate and up to date
• Handle ERA and EFT enrollment and follow-ups
• Track licenses, certifications, expirations and renewals, and manage payer revalidations
• Contact payers to check application status, resolve pending cases and obtain approvals
• Resolve insurance portal issues and submit documents through portals, email, fax and other channels
• Maintain credentialing records, follow-up logs and enrollment status reports

Required profile

• 2 to 3 years of hands-on experience in U.S. healthcare provider credentialing and payer enrollment
• Experience managing credentialing applications for medical or behavioral health providers
• Strong organizational skills, attention to detail and ability to handle multiple providers, applications and deadlines
• Good written and verbal English; ability to work independently and coordinate with the credentialing and medical billing teams

Required skills

• Working knowledge of Medicare, Medicaid and commercial payer enrollment
• Hands-on experience with CAQH profiles and attestations, ERA and EFT applications
• Navigating payer portals and submitting documents
• Microsoft Excel, Google Sheets or similar tools
• Familiarity with PECOS, NPPES or other enrollment platforms is an advantage

Working conditions

• Full-time, on-site in Gulberg 3, Lahore, Monday to Friday
• Shifts of 5:00 PM to 2:00 AM or 6:00 PM to 3:00 AM PKT, as assigned
• Salary of PKR 60,000 to 90,000 per month depending on experience and skills