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Credentialing Specialist

4 months ago


Manila, National Capital Region, Philippines Vericle Pacific Inc Full time

ClinicMind is a leading company in providing Healthcare IT and RCM services, including EHR software and medical billing in the US. We are looking for a full-time Credentialing Specialist to help us keep growing. If you're excited to be part of a winning team, ClinicMind is a perfect place to get ahead.

RESPONSIBILITIES

Handle credentialing needs for our clients (Group and/or Individual) who are US-based health care providers, diagnostic laboratories and medical facilities as preferred providers in health care networks. This entails the following tasks:

Perform credentialing work:
Collect all the required documentation for credentialing such as accreditation, membership and facility privileges (e.g., License, NPI letter).
Assist providers with completing payer forms and ensure compliance with payer's expectations
Respond to provider's inquiries as to credentialing process progress
Alert client of new regulations, expiring certificates, reapplications and deficiencies in credentialing requirements

Maintain accurate and current client information using an online database
Drive the implementation of the automated credentialing workflow management system:
Provide requirements to software developers
Review implementation

QUALIFICATIONS
  1. Minimum of 6 months experience in US-based Credentialing process
  2. Familiar with US medical insurance industry
  3. Excellent listening, communication, and problem-solving skills
  4. Self-motivated and able to work autonomously

    MUST HAVE:
    1. High comfort level working on Eastern Time Zone/US Shift
    2. Good internet access at home
    3. Mobile Hotspot
    4. Laptop/Desktop of at least 8 GB