Open to opportunities

UMAR BASHIR

@umarbashir1

I lead healthcare credentialing teams, managing provider enrollment, payer contracting, and compliant operations across states.

Pakistan

Message

What I'm looking for

I’m looking for a role where I can lead credentialing and provider enrollment operations, ensure strict HIPAA/CMS compliance, manage multi-state payer requirements, and drive strong payer contracting and client outcomes.

I’m a Credentialing Team Lead with 4+ years of experience in provider enrollment, payer contracting, healthcare compliance, and credentialing operations. I manage full-cycle workflows for Medicare, Medicaid, and commercial plans, verifying provider licenses, DEA, NPI, malpractice insurance, and board certifications while maintaining credentialing databases that meet HIPAA and CMS standards.

In my recent roles, I’ve handled multi-state Medicare, Medicaid, commercial, and IPA enrollments, keeping CAQH, PECOS, NPPES, and payer portal updates current. At IPS, I lead a 10-member credentialing team supporting 60+ healthcare clients across specialties and states—overseeing enrollment, recredentialing, payer contracting, escalations, and training new team members, while providing regular client updates on status and progress.

Experience

Work history, roles, and key accomplishments

Current

Credentialing Team Lead

Current

Ips

Jul 2025 - Present (11 months)

Lead a credentialing team of 10 members, managing day-to-day workflows for 60+ healthcare clients across multiple specialties and states. Oversee provider enrollment, recredentialing, and payer contracting for Medicare, Medicaid, and commercial plans while handling escalated CMS/payer compliance issues and training new team members.

Team Management Credentialing Full Cycle Provider Enrollment Medicare Medicaid Payer Contracting Escalation Handling

Credentialing Team Lead

Qb Solutions

Jun 2024 - Jul 2025 (1 year 1 month)

Led full-cycle credentialing and provider enrollment across multiple states for Medicare, Medicaid, commercial, and IPA enrollments. Managed CAQH, PECOS, NPPES, and payer portal updates and coordinated with billing and provider relations to resolve credentialing and claims issues.

Credentialing Medicare Medicaid Provider Enrollment CAQH PECOS NPPES Payer Contracting

Credentialing Specialist

Prg Pakistan

Aug 2022 - May 2024 (1 year 9 months)

Managed provider credentialing and enrollment for Medicare, Medicaid, and commercial insurance plans by verifying licenses, DEA, NPI, malpractice insurance, and board certifications. Maintained credentialing databases and ensured compliance with HIPAA and CMS standards.

Provider Credentialing Provider Enrollment Medicare Medicaid CAQH HIPAA compliance Credentials Databases