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Credentialing Specialist

4 weeks ago


Cebu City, Philippines Hirebiz Inc. Full time

Medical Insurance Billing & Credentialing Specialist Job Summary We’re seeking a detail-oriented and organized professional to manage healthcare provider credentialing, re-credentialing, and billing functions . This role ensures providers are properly enrolled with insurance networks and maintains compliance with regulatory standards. Key Responsibilities Process initial credentialing and re-credentialing for healthcare providers. Verify licenses, certifications, education, and other credentials. Maintain accurate and up-to-date credentialing and licensing records. Ensure compliance with all regulatory and payer requirements. Communicate with providers and insurance companies regarding credentialing status. Assist with license and DEA applications. Perform data entry for billing charges, payments, and claim status updates. Support billing projects and identify opportunities for process improvement. Qualifications At least 2 years of experience in medical credentialing, licensing, or billing. Strong knowledge of healthcare compliance and insurance regulations. Excellent communication and organizational skills. Proficient in Microsoft Office ; experience with credentialing systems a plus. CPCS or CPMSM certification preferred but not required. Work Setup On-site (Direct US Client) #J-18808-Ljbffr