Certified Credentialing Specialist

4 weeks ago

Calamba, Calabarzon, Philippines Indicle Full time

ClinicMind, the nation's leader in multi-specialty Electronic Healthcare Records (EHR) software and Revenue Cycle Management (RCM) services, is looking for a full-time Credentialing Specialist. 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. At least 2 years 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
  5. Credentialing certification is required

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
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