Summary

Adaptable, Hard working, Team Player, Eager to learn Open Source based system, Accept Challenges and Sales Pressure

Projects

Credentialing

Experience

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Credentialing Specialist
PRGMD
Nov 2015 - Present | Lahore, Pakistan

1. Compiles and maintains current and accurate data for all providers.
2. Completes provider credentialing and re-credentialing applications; monitors applications
and follows-up as needed.
3. Maintains copies of current state licenses, DEA certificates, malpractice coverage and
any other required credentialing documents for all providers.
4. Maintains corporate provider contract files.
5. Maintains knowledge of current health plan and agency requirements for credentialing
providers.
6. Sets up and maintains provider information in online credentialing databases and system.
7. Tracks license and certification expiration for all providers to ensure timely renewals.
8. Ensures practice addresses are current with health plans, agencies and other entities.
9. Processes applications for appointment and reappointment of privileges to The Doctors
Clinic (ASC).
10. Tracks license, DEA and professional liability expiration's for appointed ASC providers.
11. Maintains ASC appointment files, and information in credentialing database.
12. Audits health plan directories for current and accurate provider information.
13. Maintains confidentiality of provider information.
14. Provides credentialing and privileging verification.
15. Performs other duties as assigned

Physical Requirements:
Hearing: Adequate to perform job duties in person and over the telephone.
Speaking: Must be able to communicate clearly to patients in person and over the
telephone.
Vision: Visual acuity adequate to perform job duties, including reading information from
printed sources and computer screens.
Other: Requires occasional lifting and carrying items weighing up to 20 pounds
unassisted. Requires frequent bending, reaching, and repetitive hand movements,
standing, walking, squatting and sitting, with some lifting, pushing and pulling exerted
regularly throughout a regular work shift.

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A.R Exective
Cyber System (Pvt) Ltd.
Jan 2015 - Present | Lahore, Pakistan

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Credentialing Specialist
Transcure
Mar 2013 - Oct 2014 | Lahore, Pakistan

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business development exective
May 2013 - Jul 2013 | Lahore, Pakistan

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CSR
ibrama communications
Oct 2012 - Feb 2013 | Lahore, Pakistan

Education

Abbottabad International Medical College
Bachelors, , Bachelors of Commerce‎
Advance Accounting
2012

Skills

Intermediate Accounts Managment Skills
Intermediate Amin Management
Intermediate Commission Structures
Expert Credentialing
Intermediate End-to-End Sale
Intermediate Evaluating Risk
Intermediate Fluent in English
Intermediate h Operations Management
Intermediate High Networth Individuals
Intermediate Individuals / Consumers
Intermediate Managing Large Teams =
Beginner Opening Branch Offices
Expert Processing Knowledge
Intermediate Regional Banks
Intermediate Relations Management Skills
Intermediate Rural Markets Knowledge
Intermediate Tgs The Global Store
Intermediate كلينت فلوب
Intermediate مبيعات القناة
Intermediate مبيعات المشاركة
Beginner Vape Knowledge
Intermediate اللهجات البريطانية
Intermediate استشارات إدارة المبيعات
Intermediate تسويق الشركات

Languages

Expert English