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Credentialing Specialist

1 month ago

Manila, National Capital Region, Philippines ADEC INNOVATIONS HEALTHCARE, INC Full time

JOB SUMMARY
The Credentialing Specialist works with the team to ensure all credentialing activities are processed in a timely manner. Calling healthcare providers, such as physicians, nurses, and allied healthcare professionals, meet all the necessary qualifications and credentials required to deliver healthcare services.

JOB RESPONSIBILITIES

  1. Credential Verification: Verify the credentials, qualifications, and certifications of healthcare providers, ensuring they meet the standards set by regulatory bodies, healthcare organizations, and insurance companies.
  2. Documentation Management: Maintain accurate and up-to-date records of all healthcare provider credentials, licenses, certifications, and other pertinent information. Ensure compliance with document retention and record-keeping regulations.
  3. Communication: Collaborate with healthcare providers by calling them to collect necessary documents and information for the credentialing process. Communicate with providers, insurers, and healthcare organizations to resolve any credentialing-related issues.
  4. Compliance Monitoring: Stay updated on regulatory changes and standards relevant to healthcare provider credentialing. Ensure that providers adhere to these requirements and promptly address any non-compliance issues.
  5. Cross-Functional Collaboration: Collaborate with various departments, including human resources, compliance, and legal teams, to ensure the seamless integration of provider credentialing processes within the organization.

JOB REQUIREMENTS

  • With at least 1 year Healthcare BPO setting; experience in provider credentialing and enrollments preferred
  • Excellent attention to detail and accuracy in record-keeping.
  • Effective communication and interpersonal skills.
  • Understanding of medical terminology and healthcare provider specialties.

PERKS OF JOINING US

  • Competitive salary
  • Onsite during training and nesting period (Alabang)
  • HMO DAY1 with FREE one dependent*
  • 15% Night Differential
  • Internet Allowance
  • Rice Allowance
  • Clothing Allowance
  • Laundry Allowance
  • Meal Allowance
  • Healthy working environment
  • Free webinars and internal trainings/events and more

Our office is located at Alabang Corporate Center, Muntinlupa City.

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