Credentialing Specialist

Overview:
We are a U.S.-based medical billing and revenue cycle management company seeking a Credentialing Specialist based in the Philippines. As the primary point of contact for credentialing matters, you will liaise with clients, practice administrators, and internal teams to deliver exceptional service.

Responsibilities:
– Credential providers with health plans, hospitals, and patient care facilities.
– Maintain current provider data in credentialing databases, ensuring timely license and certification renewals.
– Develop and manage detailed credentialing grids for network participation clarity.
– Verify healthcare professionals’ credentials in compliance with state and federal standards, involving verification with universities, licensing agencies, and certification groups.
– Process re-credentialing paperwork and maintain a database of practitioners’ training, education, licensing, and experience information.
– Ensure practitioners adhere to staff policies, department regulations, and government laws.

Qualifications and Skills:
– Strong multitasking abilities with a track record of managing multiple projects simultaneously.
– Familiar with the US medical insurance industry
– Minimum of 2 years experience in US-based Credentialing process
– Ability to build and maintain effective relationships with providers, management, staff, and external contacts.
– Demonstrated history of completing credentialing projects from start to finish.
– Project management skills with the ability to supervise others’ work.
– Adherence to instructions and payer-specific guidelines.
– Highly organized and meticulous in maintaining digital files and relevant information.
– Excellent verbal and written communication skills for letters, memos, and emails.
– High comfort level working on Eastern or Pacific Time Zone/US Shift

Requirements:
-For Laptop: 8th generation (8000 series) Core i5 or better; AMD Ryzen series processors
-For Desktop: Ryzen 5 3000 series and above. If Core i3 – 10th generation or higher.
-For Mac: Core i5 – 2017 or higher Core i7 – 2016 or higher (not recommended : Core i3)
-A suitable work-from-home space in the Philippines
-Internet connection: 25 Mbps minimum

IMPORTANT: We’d love to get to know you better! Please send us a brief 1-minute intro video along with your application. Please share a Google drive link for your video. Thanks!