Credentialing Specialist
3 weeks ago
Eviden Taguig, National Capital Region, Philippines
Hiring Cash Application Associates and Insurance Team LeadAt Eviden, together we bring the diversity of our people's skills and backgrounds to make the right choices with our clients, for our company and for our own futures.
As a Credentialing Specialist, you'll work closely with a variety of healthcare organizations to ensure the credentials of medical professionals are impeccable. By verifying and auditing credentials, you'll be part of a team devoted to upholding standards of excellence and providing the highest level of care to patients.
Shift Schedule: Nightshift
Work Setup: Full Onsite during training and Hybrid after
Responsibilities & Duties- Manage the credentialing process for healthcare providers, including physicians, nurses, and other licensed professionals.
- Verify the accuracy and completeness of provider applications, ensuring that all required documents are submitted.
- Conduct thorough background checks, license verifications, and references to ensure compliance with regulatory standards.
- Coordinate with internal departments and external agencies to obtain and update relevant provider information.
- Maintain accurate and up-to-date electronic and hard copy files of all credentialing documentation.
- Communicate with providers to address any discrepancies or missing information.
- Monitor expiring licenses and credentials, proactively initiating the renewal process to avoid any disruption in services.
- Stay up-to-date with industry regulations and requirements, ensuring compliance at all times.
- Assist in preparing for and participating in audits and regulatory reviews.
- Provide support and guidance to internal staff regarding credentialing and privileging processes.
- Bachelor's degree in healthcare administration, business, or related field
- Experience with credentialing in a medical or healthcare setting
- Strong knowledge of industry regulations, such as the National Committee for Quality Assurance (NCQA) and The Joint Commission (TJC) standards.
- Proficient in using credentialing software (Proview CAQH) and databases for data entry and maintenance.
- Strong organizational and time-management skills
- Excellent attention to detail
- Strong communication and interpersonal skills
Company Website: Eviden | Expanding Possibilities across Data & Technology
Company Video: Watch here
Seniority levelAssociate
Employment typeFull-time
Job functionAdministrative, Health Care Provider, and Other
IndustriesIT Services and IT Consulting
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