Healthcare Provider Credentialing Specialist - Remote
RemotePhilippines or Makati, Cagayan Valley, Republic of the Philippines
Philippines or Makati, Cagayan Valley, Republic of the PhilippinesRemoteFull TimeMid LevelLarge
Full TimeMid LevelLarge
Job Summary
Coordinate and manage credentialing services for healthcare providers and practices, preparing, processing, and monitoring applications for initial and recredentialing. Monitor documents within the credentialing database to ensure quality and accuracy, then organize, label, and securely store all supporting documentation. Communicate with providers and payers to ensure proper enrollment and timely completion, while training staff on application usage. Maintain accurate records throughout the lifecycle and comply with all federal, state, and company policies.
Required Qualifications
- Call Center/BPO experience
- At least 2 years of healthcare BPO experience involving provider credentialing
- provider credentialing experience
- familiarity with industry-recognized standards
- working knowledge of Adobe Acrobat PDF
- In-depth knowledge of healthcare terminology, eligibility, benefits, medical/dental claims, and healthcare process flows
- Willing to work shifting schedules, graveyard shifts, holidays, and weekends when required
- Candidate residing in Metro Manila or nearby provinces
- Stable internet connection of at least 35 Mbps
- Dedicated workspace suitable for remote work
- Can start ASAP
Desired Qualifications
- College degree (Associate's or Bachelor's degree)
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