Healthcare Credentialing Administrator

Overview

Role: Healthcare Credentialing Administrator at MicroSourcing .

Work setup & shift: Onsite | Night shift

Salary Package: PHP45,000 - PHP55,000

What you'll get

• Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one, plus one or more dependents, paid time-off with cash conversion, group life insurance, and performance bonuses
• A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
• Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
• Career Growth: Take advantage of opportunities for continuous learning and career advancement.
• Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role

• Credentialing & Re-Credentialing
  • Coordinate and complete initial and re-credentialing processes for all healthcare providers.
  • Collect, verify, and analyze primary source documentation including licenses, certifications, DEA, malpractice insurance, education, work history, and references.
  • Ensure timely completion of credentialing and re-credentialing applications per NCQA, CMS, and payer guidelines.
  • Maintain current knowledge of state/federal regulations, payer requirements, and accreditation standards related to credentialing.
  • Complete payer enrollment and re-enrollment processes with Medicare, Medicaid, and commercial insurance carriers.
  • Track and monitor progress of enrollment applications; follow up regularly to ensure timely approvals.
  • Ensure NPI, CAQH, and PECOS profiles are current and accurate for all providers.
  • Collaborate with billing and revenue cycle teams to prevent claim denials related to provider enrollment.

Database Management & Audits

• Maintain credentialing software and document management systems with accurate and updated provider records.
• Generate reports for expiring documents, credentialing status, and payer enrollment progress.
• Assist with internal and external audits; ensure compliance documentation is readily available.

Communication & Compliance

• Communicate with providers, payers, and internal stakeholders regarding credentialing status, missing documents, or upcoming expirations.
• Ensure providers are credentialed and enrolled before start dates to prevent billing disruptions.
• Stay informed of changes in regulations, accreditation standards (e.g., The Joint Commission, NCQA), and payer policies.

What You Need

• High school diploma or GED required; Associate or bachelor\'s degree in healthcare administration or related field preferred.
• Minimum 2–3 years of credentialing and enrollment experience in a healthcare setting.
• Strong knowledge of provider credentialing, CAQH, PECOS, NPPES, Medicare/Medicaid enrollment, and commercial payer requirements.
• Familiarity with credentialing software (e.g., Modio, IntelliCred, Verity, or similar).
• Excellent attention to detail and organizational skills.
• Ability to handle confidential information with integrity and discretion.
• Strong written and verbal communication skills.
• Ability to work independently and meet deadlines.

Preferred skills/expertise

• Associate or bachelor\'s degree in healthcare administration or related field preferred.
• Certified Provider Credentialing Specialist (CPCS) or Certified Professional Medical Services Management (CPMSM) through NAMSS.

About MicroSourcing

With over 9,000 professionals across 13 delivery centers, MicroSourcing is the pioneer and largest offshore provider of managed services in the Philippines.

Our commitment to 100% YOU

MicroSourcing firmly believes that our company\'s strength lies in our people\'s diversity and talent. We are proud to foster an inclusive culture that embraces individuals of all races, genders, ethnicities, abilities, and backgrounds. We provide space for everyone, embracing different perspectives, and making room for opportunities for each individual to thrive.

At MicroSourcing, equality is not merely a slogan – it\'s our commitment. Our way of life. Here, we don\'t just accept your unique authentic self - we celebrate it, valuing every individual\'s contribution to our collective success and growth. Join us in celebrating YOU and your 100%

For more information, visit

Terms and conditions apply.

Details

• Seniority level: Mid-Senior level
• Employment type: Full-time
• Job function: Health Care Provider and Customer Service
• Industries: Outsourcing and Offshoring Consulting

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