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M. Shahbaz
@mshahbaz8533
Credentialing Specialist, Provider Enrollment, Medicare, Medicaid, Commercial
Pakistan
Englisch
Über mich
Credentialing Specialist experienced in provider enrollment, insurance credentialing, medical billing, and revenue cycle management (RCM). Skilled in Medicare, Medicaid, and commercial payer enrollment, handling the full credentialing lifecycle including CAQH management, NPI registration, PECOS enrollment, and provider revalidation. Expertise in credentialing audits, healthcare compliance, and payer contracting support to prevent billing delays and maintain accurate reimbursements. Proven ability to streamline credentialing workflows, and support efficient healthcare operations.
Kompetenzen
M. Shahbaz
offline •
Durchschnittliche Antwortzeit: 1 Stunde
Meine Dienstleistungen
Allgemeine Unterstützung
I will handle medical credentialing and provider enrollment
Arbeitserfahrung
Senior Credentialing Specialist
UForce Solutions • Vollzeit
Apr 2025 - Present • 1 yr 1 mo
- Managed upto 500+ provider credentialing and enrollment applications with Medicare, Medicaid, and commercial insurance payers, ensuring compliance with payer guidelines and healthcare regulations. - Maintained and updated CAQH profiles, supporting provider onboarding, revalidation, and credential renewals. - Verified provider licenses, certifications, NPI details, and accreditations to ensure accurate credentialing submissions. - Collaborated with medical billing teams to support Revenue Cycle Management (RCM) and minimize reimbursement delays. - Conducted payer follow-ups and resolved enrollment queries to ensure timely approvals and panel participation. - Assisted with credentialing audits and CLIA applications, maintaining regulatory compliance standards. - Maintained accurate provider documentation, credentialing records, and tracking reports using Excel and Outlook.
Credentialing Specialist
Integrity Revenue Cycle Management • Vollzeit
Feb 2024 - Apr 2025 • 1 yr 2 mos
- Managed provider credentialing and enrollment for Medicare, Medicaid, and commercial insurance payers at Integrity RCM. - Processed 500–600+ credentialing and re-credentialing applications with a strong approval success rate. - Verified provider documentation including licenses, NPI registration, and CAQH profile management. - Completed PECOS enrollment and payer portal submissions for new provider onboarding. - Resolved payer enrollment queries and documentation issues through consistent follow-ups with insurance panels. - Maintained accurate provider records, rosters, and payer status updates across credentialing systems. - Ensured payer compliance and regulatory standards to prevent billing delays and claim rejections. - Supported smooth revenue cycle management (RCM) by enabling timely provider credentialing and uninterrupted reimbursement.
Medical Laboratory Technologist
Mohsin Medical Laboratory • Vollzeit
Jun 2023 - Sep 2023 • 3 mos
- Completed a hands-on internship as a Medical Laboratory Technologist, performing phlebotomy and diagnostic sample collection. - Assisted with hematology testing and routine laboratory procedures following standard clinical protocols. - Supported sample processing, labeling, and reporting to ensure accurate diagnostic results. - Followed laboratory quality standards, safety protocols, and compliance guidelines. - Maintained medical documentation and laboratory records to support efficient healthcare operations. - Gained practical exposure to clinical laboratory workflows, diagnostic testing, and healthcare compliance practices.
