Ateeb Javed
Credentialing & Enrollments Specialist
Lahore, Punjab
Summary
Revenue Cycle Management (RCM) Specialist experienced in credentialing and enrollment processes, including CAQH management and insurance paneling with commercial and government payers. Delivered comprehensive support through effective handling of provider documentation, payer follow-ups, and compliance with payer requirements. Focused on optimizing claims management and reimbursement workflows while maintaining HIPAA compliance.
Overview
2
2
Languages
6
6
years of professional experience
Work History
RCM Specialist
HRMD Solutions
08.2025 - Current
- Managed complete Revenue Cycle Management (RCM) processes for US healthcare providers.
- Performed patient eligibility and benefits verification through insurance portals and calls.
- Generated and reviewed patient statements for outstanding balances and payment follow-up.
- Handled medical billing processes including claim creation, submission, and resubmission.
- Performed accurate payment posting for insurance and patient payments.
- Managed AR follow-up for denied, rejected, and unpaid claims to maximize reimbursements.
- Communicated with insurance representatives regarding claim status, denials, and appeals.
- Created and managed provider and payer portal accounts for billing and enrollment operations.
- Assisted in provider enrollment and credentialing with commercial and government payers.
- Maintained CAQH profiles, provider documents, and enrollment records.
- Submitted corrected claims and appeals to resolve payment delays and denials.
- Worked with Medicare, Medicaid, and commercial insurance portals.
- Ensured accurate documentation and HIPAA compliance throughout billing operations.
- Monitored aging reports and prioritized high-value AR accounts for timely collections.
- Coordinated with providers and internal teams to resolve billing and enrollment issues.
- Verified patient demographics, insurance details, and billing information before claim submission.
- Improved claim acceptance rate through accurate billing and timely follow-up.
- Maintained daily productivity and quality standards in fast-paced US healthcare environments.
Credentialing & Enrollments Specialist
Express Solutions
07.2023 - 08.2025
- Managed provider credentialing processes to ensure compliance with regulatory standards.
- Coordinated documentation collection and verification from healthcare providers for credentialing applications.
- Maintained accurate databases tracking provider credentials and certifications for timely renewals.
- Assisted in streamlining credentialing workflows, improving processing times and efficiency.
- Collaborated with healthcare providers to gather necessary information for accurate credentialing decisions.
- Managed multiple priorities effectively, resulting in the on-time completion of credentialing tasks for numerous providers simultaneously.
- Conducted audits of provider files, ensuring all necessary documents were up-to-date and compliant with regulatory requirements.
- Conducted primary source verifications such as background checks and board certifications.
- Facilitated communication between departments, resulting in improved collaboration during the credentialing process.
- Managed provider credentialing and re-credentialing processes with commercial and government payers.
- Completed provider enrollment applications for Medicare, Medicaid, and commercial insurance panels.
- Maintained accurate provider records and ensured compliance with payer requirements.
- Coordinated with insurance companies for application follow-up and status updates.
- Verified provider documents including licenses, DEA, malpractice insurance, and certifications.
- Assisted in CAQH profile creation, updating, and attestation processes.
- Monitored credentialing expirations and ensured timely renewals.
- Worked on provider demographic updates and contract-related documentation.
- Communicated with healthcare providers and insurance representatives to resolve enrollment issues.
- Ensured timely submission of credentialing applications to minimize delays in provider participation.
- Maintained confidentiality and HIPAA compliance while handling provider information.
- Tracked credentialing status and maintained reports for management review.
- Experience working with payer portals and credentialing software systems.
- Assisted in resolving enrollment denials and application discrepancies.
- Supported smooth onboarding of healthcare providers into insurance networks.
- Successfully handled multiple provider enrollments with accurate and timely submissions.
- Reduced credentialing delays through proactive payer follow-up and documentation management.
- Improved enrollment turnaround time by maintaining organized credentialing workflows
AR Specialist
Physicians Revenue Group, INC
07.2021 - 07.2022
- Processed and reconciled accounts receivable transactions to ensure accuracy and timeliness.
- Increased customer satisfaction levels by promptly addressing inquiries regarding billing issues or adjustments needed on their accounts.
- Assisted in resolving billing discrepancies and customer inquiries effectively.
- Monitored account statuses, providing updates and recommendations for outstanding collections.
- Analyzed payment trends to identify opportunities for operational efficiencies within the department.
- Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
Eligibility Specialist
Zmed Solutions, PVT. LTD
07.2020 - 06.2021
- Determined patient eligibility over calls and portal; initiated prior authorization processes as needed.
- Maintained accurate records in electronic health systems, enhancing data integrity and retrieval.
- Scheduled patient appointments to collect information and clarify benefits processes.
- Filed and updated patient information and medical records.
- Collected payments and applied to patient accounts.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Guided clients in completing eligibility forms, applications, and required documentation.
- Communicated with people from various cultures and backgrounds on application process.
- Collaborated with team members to streamline workflows and improve operational efficiency within the department.
Education
Bachelor of Science - Chemistry
Minhaj University
Lahore, Punjab, Pakistan 04.2001 -
Intermediate - Pre-Engineering
Govt. Degree College Model Town
Lahore, Punjab, Pakistan 04.2001 -
Matriculation - Biology
Divisional Public School
Model Town, Lahore 04.2001 -
Skills
Healthcare software
Quality assurance
Audit reporting
Problem-solving
Team performance improvement
Time management
Task prioritization
Multitasking
Professionalism
Team leadership
Team collaboration
Effective communication
Timeline
RCM Specialist
HRMD Solutions
08.2025 - Current
Credentialing & Enrollments Specialist
Express Solutions
07.2023 - 08.2025
AR Specialist
Physicians Revenue Group, INC
07.2021 - 07.2022
Eligibility Specialist
Zmed Solutions, PVT. LTD
07.2020 - 06.2021
Bachelor of Science - Chemistry
Minhaj University
04.2001 -
Intermediate - Pre-Engineering
Govt. Degree College Model Town
04.2001 -
Matriculation - Biology
Divisional Public School
04.2001 -