Credentialing Analyst

4 weeks ago

Taguig, Philippines John Clements Consultants, Inc. Full time

Responsibilities Handle timely and accurate initial credentialing and re-credentialing of network practitioners, including primary source verification and other documentation requirements. Support the Credentialing Manager in conducting regulatory compliance audits and preparing detailed reports with findings and recommendations. Collaborate with leadership to review and enhance department policies, procedures, and quality standards. Monitor expiring credentials and complete re-verifications in accordance with applicable regulations. Process provider applications for initial and re-appointment; ensure completion, elevate issues as needed, and prepare profiles for review. Maintain and update provider demographic information and ensure data accuracy across systems. Perform proactive and reactive monitoring, quality audits, and support access requests as necessary. Qualifications Bachelor’s degree in any field. At least 1 year of experience in credentialing, provider enrollment, or a similar function within healthcare, BPO, or shared services. Experience in HR background checks or employment verification in the medical field. Open to a hybrid work setup and night shift schedule (initially in-office during onboarding). #J-18808-Ljbffr

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